Healthcare Provider Details

I. General information

NPI: 1942370234
Provider Name (Legal Business Name): ROBERT GIANFROCCO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 S COUNTY TRL
EAST GREENWICH RI
02818-1465
US

IV. Provider business mailing address

PO BOX 229
WAKEFIELD RI
02880-0229
US

V. Phone/Fax

Practice location:
  • Phone: 401-471-6740
  • Fax: 401-471-6753
Mailing address:
  • Phone: 401-788-3337
  • Fax: 401-788-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO00526
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number038692
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO00526
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: