Healthcare Provider Details

I. General information

NPI: 1598822348
Provider Name (Legal Business Name): DONNA ELLEN ANNICELLI M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TOLL GATE RD
WARWICK RI
02886-4440
US

IV. Provider business mailing address

505 CEDAR AVE
EAST GREENWICH RI
02818-2605
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-1760
  • Fax: 401-737-1740
Mailing address:
  • Phone: 401-884-0496
  • Fax: 401-884-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAUD00166
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: