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General NPI Number Information
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NPI Number | 1578547212
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Entity Type | Individual
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Provider Name | NAOMI Y MCMACKIN MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MEMORIAL HOSPITAL OF RI 111 BREWSTER STREET
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City | PAWTUCKET
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State | RI
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Zip | 02860-1400
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Country | US
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Telephone | 401-729-2000
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Fax |
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Provider Business Mailing Address
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Address Line | MEMORIAL HOSPITAL OF RI 111 BREWSTER STREET
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City | PAWTUCKET
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State | RI
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Zip | 02860-1400
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Country | US
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Telephone | 401-729-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD11907
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License Number State | RI
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