MEDICARE: LYNN MCNICOLL 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD10775	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265486443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN MCNICOLL MD

Provider Business Mailing Address
First Line	:	17 VIRGINIA AVE
Second Line	:	SUITE 107
City	:	PROVIDENCE
State	:	RI
Zip	:	02905-4406
Country	:	US
Telephone Number	:	401-443-4992
Fax Number	:	401-784-4902

Provider Business Practice Location Address
First Line	:	375 WAMPANOAG TRL
Second Line	:	SUITE 102
City	:	RIVERSIDE
State	:	RI
Zip	:	02915-2212
Country	:	US
Telephone Number	:	401-649-4010
Fax Number	:	401-649-4011

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/27/2016

Similar Medicare Providers

1417955071 — MARINA F RODRIGUEZ MD
Practice Location Address:

375 WAMPANOAG TRL , SUITE 201
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4020
Practice Fax: 401-649-4021

1619924651 — FADLALLAH G HABR MD
Practice Location Address:

375 WAMPANOAG TRL , SUITE 202A
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4030
Practice Fax: 401-649-4031

1235186735 — STEVEN F MOSS MD
Practice Location Address:

375 WAMPANOAG TRL , SUITE 202A
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4030
Practice Fax: 401-649-4031

1285671990 — RICHARD BESDINE MD
Practice Location Address:

375 WAMPANOAG TRL , SUITE 102
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4010
Practice Fax: 401-649-4011

1679687289 — DR. PETER AMBERG HOLLMANN MD
Practice Location Address:

375 WAMPANOAG TRL , SUITE 102
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4010
Practice Fax: 401-649-4011

1033291570 — THOMAS D DENUCCI M.D.
Practice Location Address:

375 WAMPANOAG TRL , SUITE 202A
RIVERSIDE, RI
02915-2212

Practice Phone: 401-649-4030
Practice Fax: 401-649-4031

Directions to “ LYNN MCNICOLL 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.