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General NPI Number Information
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NPI Number | 1942479860
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Entity Type | Organization
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Legal Business Name | JOSEPH DIBENEDETTO JR MD INC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 193 WATERMAN ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-4014
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Country | US
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Telephone | 401-351-4470
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Fax | 401-351-0163
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Provider Business Mailing Address
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Address Line | 193 WATERMAN ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-4014
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Country | US
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Telephone | 401-351-4470
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Fax | 401-351-0163
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Authorized Official
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Title or Position | RN,BSN,OCN, PRACTICE MANAGER
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Name | PATRICIA W. DIBENEDETTO
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Credential |
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Telephone | 401-351-4470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD004989
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License Number State | RI
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