Healthcare Provider Details

I. General information

NPI: 1982687539
Provider Name (Legal Business Name): PATRICIA P KAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 PROVIDENCE ST
WEST WARWICK RI
02893-2508
US

IV. Provider business mailing address

450 CLINTON ST
WOONSOCKET RI
02895-3207
US

V. Phone/Fax

Practice location:
  • Phone: 401-615-2800
  • Fax: 401-615-2805
Mailing address:
  • Phone: 401-767-4100
  • Fax: 401-235-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD12205
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD12205
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: