Healthcare Provider Details

I. General information

NPI: 1871502526
Provider Name (Legal Business Name): LINDA A CARRO RD, CDOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

IV. Provider business mailing address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-736-4678
  • Fax: 401-736-4212
Mailing address:
  • Phone: 401-736-4678
  • Fax: 401-736-4212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number00096
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: