Healthcare Provider Details

I. General information

NPI: 1497877534
Provider Name (Legal Business Name): VINCENT A. D'ALESSANDRO, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1857 ATWOOD AVE
JOHNSTON RI
02919-7206
US

IV. Provider business mailing address

1857 ATWOOD AVE
JOHNSTON RI
02919-7206
US

V. Phone/Fax

Practice location:
  • Phone: 401-231-3300
  • Fax: 401-232-0190
Mailing address:
  • Phone: 401-231-3300
  • Fax: 401-232-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3506
License Number StateRI

VIII. Authorized Official

Name: SHERRI LYNN BONAMINIO
Title or Position: OFFICE MANAGER
Credential:
Phone: 401-231-3300