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General NPI Number Information
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NPI Number | 1588893895
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Entity Type | Individual
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Provider Name | KENNY CORREIA PHARMD, CDOE, CVDOE
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Gender | Male
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 4300 POST RD
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City | EAST GREENWICH
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State | RI
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Zip | 02818-4203
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Country | US
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Telephone | 401-889-3669
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Fax | 401-884-2573
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Provider Business Mailing Address
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Address Line | 106 NATE WHIPPLE HWY STE 101
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City | CUMBERLAND
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State | RI
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Zip | 02864-1403
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Country | US
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Telephone | 401-658-2020
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Fax | 401-658-3612
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | RPH04819
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | RPH04819
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH04819
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH232913
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | RPH04819
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License Number State | RI
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Taxonomy #6
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH04819
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License Number State | RI
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