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1184690299

NPI Code Detail

MEDICARE: DR. GINA GERARDINE LA PROVA MD

MEDICARE: DR. GINA GERARDINE LA PROVA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	224304	MA
2	207Q00000X	Family Medicine Physician	MD10894	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	92588701	OTHER		NETWORK HEALTH
2	21435-7	OTHER	RI	BCBS OF RHODE ISLAND
3	AA309012	OTHER		HARVARD PILGRIM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1184690299	OTHER		NEIGHBORHOOD HEALTH PLAN
6	042297845	OTHER		TRICARE
7	042297845	OTHER		UNITED HEALTH CARE
8	042297845	OTHER		HCVM
9	1184690299	OTHER		FALLON
10	7981290	OTHER		AETNA
11	010894	OTHER		TUFTS AND TUFTS MED PREFERRED
12	042297845	OTHER		GIC/UNICARE
13	J46491	OTHER	MA	BCBSMA

General Provider Information

NPI Number	:	1184690299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINA GERARDINE LA PROVA MD

Provider Business Mailing Address
First Line	:	2140 MENDON RD
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-3843
Country	:	US
Telephone Number	:	401-642-2072
Fax Number	:	401-305-3958

Provider Business Practice Location Address
First Line	:	2140 MENDON RD
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-3843
Country	:	US
Telephone Number	:	401-642-2072
Fax Number	:	401-305-3958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	03/24/2017

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Directions to “ DR. GINA GERARDINE LA PROVA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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