CHANIKA PHORNPHUTKUL MD NPI 1639124530

NPI Information

NPI: 1639124530
Provider Name: CHANIKA PHORNPHUTKUL, MD
Classification: Medical Genetics - 207SG0202X
Entity Type: Individual

Specialization: Clinical Biochemical Genetics

PECOS Registration: Yes

Address:
593 EDDY ST
PROVIDENCE, RI
ZIP 02903
Phone: (401) 444-8361
Get Directions

Chanika Phornphutkul, MD is a clinical biochemical genetics medical genetics in Providence, RI with 32 years of experience. The provider is a clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management of human genetic diseases and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders. Chanika Phornphutkul, MD NPI is 1639124530. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

593 EDDY ST
PROVIDENCE, RI
ZIP 02903-923
Phone: (401) 444-8361
Fax: (401) 444-3288

The NPI 1639124530 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 12/21/2011.

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	2080P0205X	Pediatrics	Pediatric Endocrinology	10121	RHODE ISLAND	No
2	207SG0202X	Medical Genetics	Clinical Biochemical Genetics	MD10121	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
1	CP46587	MEDICAID	RHODE ISLAND
2	H71415	MEDICARE UPIN	RHODE ISLAND
3	007010049	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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