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NPI Code Detail

MEDICARE: RAFAEL ENRIQUE LIPORACI LUCENA MD

MEDICARE: RAFAEL ENRIQUE LIPORACI LUCENA 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
1207R00000XInternal Medicine PhysicianMD15059RI

General Provider Information

NPI Number : 1366715633
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAFAEL ENRIQUE LIPORACI LUCENA MD
Provider Business Mailing Address
First Line : 3 REGENCY PLZ
Second Line : APT 709E
City : PROVIDENCE
State : RI
Zip : 02903-3161
Country : US
Telephone Number : 917-297-0916
Fax Number :
Provider Business Practice Location Address
First Line : 174 ARMISTICE BLVD
Second Line :
City : PAWTUCKET
State : RI
Zip : 02860-3280
Country : US
Telephone Number : 401-723-7578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2012
Last Update Date : 07/14/2015

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