Healthcare Provider Details

I. General information

NPI: 1851348353
Provider Name (Legal Business Name): SARA F NUGENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 W RIVER ST
PROVIDENCE RI
02904-2609
US

IV. Provider business mailing address

146 W RIVER ST
PROVIDENCE RI
02904-2609
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-5700
  • Fax: 401-793-7801
Mailing address:
  • Phone: 401-793-5700
  • Fax: 401-793-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD07559
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: