Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD12346 | RI |
NPI | 1215933908 |
---|---|
Provider Name | Rachel Allison Altura |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215933 | (05) | RI |
H02590 | (02) | RI |
MD12346 | LICENSE (01) | RI |