DR. BREA SHAY PRINDAVILLE M.D. NPI 1912134529

NPI Information

  • NPI: 1912134529
  • Provider Name: DR. BREA SHAY PRINDAVILLE, M.D.
  • Classification: Dermatology - 207NP0225X
  • Specialization: Pediatric Dermatology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 148 W RIVER ST STE 1B
    PROVIDENCE, RI
    ZIP 02904
  • Phone: (401) 273-9310

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NPI Details

DR. Brea Shay Prindaville, M.D. is a pediatric dermatology dermatology in Providence, RI. The provider is a pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. DR. Brea Shay Prindaville, M.D. NPI is 1912134529. 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:

148 W RIVER ST STE 1B
PROVIDENCE, RI
ZIP 02904
Phone: (401) 273-9310
Fax: (401) 273-1270

The NPI 1912134529 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 6/22/2009 and was last updated on 8/6/2024.

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
1207N00000XDermatology15774RHODE ISLANDNo
2207N00000XDermatology265523MASSACHUSETTSNo
3207NP0225XDermatologyPediatric Dermatology265523MASSACHUSETTSNo
4207NP0225XDermatologyPediatric Dermatology15774RHODE ISLANDNo
5208000000XPediatrics15774RHODE ISLANDNo
6207NP0225XDermatologyPediatric DermatologyMD15774RHODE ISLANDYes

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: 11/21/2025

NPI Synchronization or Removal

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