BLACKSTONE VALLEY FOOT AND ANKLE INC. NPI 1720482193

NPI Information

NPI: 1720482193
Provider Name: BLACKSTONE VALLEY FOOT AND ANKLE INC.
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
345 ARMISTICE BLVD
PAWTUCKET, RI
ZIP 02861
Phone: (401) 725-5576
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BLACKSTONE VALLEY FOOT AND ANKLE INC. is a foot and ankle surgery podiatrist in Pawtucket, RI. BLACKSTONE VALLEY FOOT AND ANKLE INC. NPI is 1720482193. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

345 ARMISTICE BLVD
PAWTUCKET, RI
ZIP 02861-429
Phone: (401) 725-5576
Fax: (401) 725-2640

The provider's authorized official is Joseph Kevin Domenico .
The authorized official title is Owner and has the following contact phone number (401) 725-5576.

The enumeration date for this NPI number is 10/14/2014 and was last updated on 4/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	DPM00327	RHODE ISLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7369700001	MEDICARE NSC	RHODE ISLAND
2	U400131218	MEDICARE PIN	RHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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