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General NPI Number Information
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NPI Number | 1841466364
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Entity Type | Organization
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Legal Business Name | CUMBERLAND PEDIATRICS, INC.
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 132 OLD RIVER RD SUITE 107
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City | LINCOLN
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State | RI
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Zip | 02865-1161
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Country | US
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Telephone | 401-334-3388
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Fax | 401-334-3389
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Provider Business Mailing Address
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Address Line | 132 OLD RIVER RD SUITE 107
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City | LINCOLN
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State | RI
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Zip | 02865-1161
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Country | US
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Telephone | 401-334-3388
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Fax | 401-334-3389
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOUIS A COLANTONIO
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Credential | MD
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Telephone | 401-334-3388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD04611
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License Number State | RI
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