Healthcare Provider Details

I. General information

NPI: 1205470267
Provider Name (Legal Business Name): CHRISTINE PAIGE MEDICAL SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2019
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PLAIN ST STE 204
PROVIDENCE RI
02905-3241
US

IV. Provider business mailing address

PO BOX 23103
PROVIDENCE RI
02903-0390
US

V. Phone/Fax

Practice location:
  • Phone: 401-256-9895
  • Fax:
Mailing address:
  • Phone: 401-256-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberHI19128
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberHI19128
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: