Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | MD09793 | RI |
NPI | 1184638017 |
---|---|
Provider Name | Lynne Palmisciano |
First Address | Providence, RI 02940-9484 |
Second Address | Providence, RI 02903-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 18/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04/15/2009 | UNITED HEALTHCARE (01) | RI |
06/01/2009 | BCBS (01) | RI |
10/08/2009 | NHPRI (01) | RI |
1184638017 | NPI (01) | RI |
12/29/2008 | TUFTS HEALTH PLAN (01) | MA |
3201988 | (05) | MA |
7006718 | (05) | RI |
939025129 | RI MEDICARE GROUP NUMBER (01) | RI |
G51599 | (02) | RI |