Healthcare Provider Details

I. General information

NPI: 1972614733
Provider Name (Legal Business Name): GILBERT J ALTONGY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 BROAD STREET
CENTRAL FALLS RI
02863
US

IV. Provider business mailing address

PO BOX 70
ALBION RI
02802-0070
US

V. Phone/Fax

Practice location:
  • Phone: 401-723-9250
  • Fax: 401-728-0301
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD05204
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: