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NPI Code Detail

MEDICARE: PEPPINO E TETTEY M.D.

MEDICARE: PEPPINO E TETTEY M.D.
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 PhysicianMD10728RI
2208M00000XHospitalist PhysicianMD10728RI
3207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD10728RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
229884-3OTHERRIBC/BS
3410635OTHERRIBLUECHIP

General Provider Information

NPI Number : 1578553830
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEPPINO E TETTEY M.D.
Provider Business Mailing Address
First Line : 275 BROADWAY
Second Line : UNIT 2
City : NEWPORT
State : RI
Zip : 02840-2612
Country : US
Telephone Number : 401-845-1472
Fax Number : 401-846-4874
Provider Business Practice Location Address
First Line : 11 FRIENDSHIP ST
Second Line :
City : NEWPORT
State : RI
Zip : 02840-2271
Country : US
Telephone Number : 401-846-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 03/16/2011

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Directions to “ PEPPINO E TETTEY M.D.” Practice Location

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