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General NPI Number Information
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NPI Number | 1770302242
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Entity Type | Individual
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Provider Name | GLORIA BONGIORNO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 200 HIGH SERVICE AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5113
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Country | US
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Telephone | 401-456-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 42 BERKSHIRE DR
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City | ALBION
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State | RI
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Zip | 02802-1112
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Country | US
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Telephone | 401-374-6534
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN04300
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN2262916
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License Number State | MA
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