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General NPI Number Information
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NPI Number | 1649452798
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Entity Type | Individual
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Provider Name | CORRINE E FISCHER RD
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Gender | Female
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 450 VETERANS MEMORIAL PKWY STE 10
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-5300
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Country | US
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Telephone | 401-413-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 98 10TH ST FL 2
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City | PROVIDENCE
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State | RI
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Zip | 02906-2920
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Country | US
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Telephone | 401-413-0212
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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 | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 2654
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 00650
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License Number State | RI
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