Healthcare Provider Details

I. General information

NPI: 1558478032
Provider Name (Legal Business Name): JOHN ROBERT PARZIALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 VETERANS MEMORIAL PKWY BUILDING 12
EAST PROVIDENCE RI
02914-5300
US

IV. Provider business mailing address

450 VETERANS MEMORIAL PKWY BUILDING 12
EAST PROVIDENCE RI
02914-5300
US

V. Phone/Fax

Practice location:
  • Phone: 401-435-2288
  • Fax: 401-435-2282
Mailing address:
  • Phone: 401-435-2288
  • Fax: 401-435-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number6916
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: