Healthcare Provider Details

I. General information

NPI: 1093005035
Provider Name (Legal Business Name): MICHAEL RONALD CIPRIANO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 POWER RD
PAWTUCKET RI
02860-3329
US

IV. Provider business mailing address

342 POWER RD
PAWTUCKET RI
02860-3329
US

V. Phone/Fax

Practice location:
  • Phone: 401-724-3274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH04761
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: