MEDICARE: DAVID A CARCIERI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD08594	RI

General Provider Information

NPI Number	:	1265440598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID A CARCIERI MD

Provider Business Mailing Address
First Line	:	1637 MINERAL SPRING AVE
Second Line	:	SUITE 211
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4042
Country	:	US
Telephone Number	:	401-353-0757
Fax Number	:	401-223-3549

Provider Business Practice Location Address
First Line	:	1637 MINERAL SPRING AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4042
Country	:	US
Telephone Number	:	401-353-0757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	03/26/2021

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