Healthcare Provider Details

I. General information

NPI: 1417926890
Provider Name (Legal Business Name): NICOLE P SOMVANSHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1598 S COUNTY TRL STE 115
EAST GREENWICH RI
02818-1762
US

IV. Provider business mailing address

10 DAVOL SQ STE 400
PROVIDENCE RI
02903-4752
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-0333
  • Fax: 401-884-0096
Mailing address:
  • Phone: 401-539-0283
  • Fax: 401-539-6741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD11818
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: