Healthcare Provider Details

I. General information

NPI: 1518969195
Provider Name (Legal Business Name): IBRAHIM A. ELGABRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 SOCIAL ST SUITE #100
WOONSOCKET RI
02895
US

IV. Provider business mailing address

191 SOCIAL ST SUITE #100
WOONSOCKET RI
02895
US

V. Phone/Fax

Practice location:
  • Phone: 401-597-6500
  • Fax: 401-597-6509
Mailing address:
  • Phone: 401-597-6500
  • Fax: 401-597-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD13508
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07714300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD430853
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number253653
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: