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General NPI Number Information
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NPI Number | 1679528780
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Entity Type | Individual
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Provider Name | PAUL JOSEPH DIBIASE JR. RPH, CDOE
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 198 BUTTONWOODS AVE
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City | WARWICK
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State | RI
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Zip | 02886-7541
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Country | US
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Telephone | 401-739-4330
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Fax | 401-732-8316
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Provider Business Mailing Address
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Address Line | 198 BUTTONWOODS AVE
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City | WARWICK
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State | RI
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Zip | 02886-7541
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Country | US
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Telephone | 401-739-4330
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Fax | 401-732-8316
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3613
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License Number State | RI
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