Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD08764 | RI |
NPI | 1063466282 |
---|---|
Provider Name | Reginald Y Gohh |
First Address | Providence, RI 02905-4406 |
Second Address | Riverside, RI 02915-2232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 08/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2095084 | (05) | MA |
9025147 | (05) | RI |