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NPI Code Detail

MEDICARE: OLIVIER M GHERARDI

MEDICARE: OLIVIER M GHERARDI
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
1207Q00000XFamily Medicine Physician270994MA
2207Q00000XFamily Medicine PhysicianDO00489RI

General Provider Information

NPI Number : 1558324970
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIER M GHERARDI
Provider Business Mailing Address
First Line : 117 ELLENFIELD ST STE 101
Second Line :
City : PROVIDENCE
State : RI
Zip : 02905-4541
Country : US
Telephone Number : 401-444-6779
Fax Number : 401-444-6912
Provider Business Practice Location Address
First Line : 17 AIRPORT RD
Second Line :
City : WARWICK
State : RI
Zip : 02889-1001
Country : US
Telephone Number : 401-606-2520
Fax Number : 401-384-7190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 06/13/2019

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Directions to “ OLIVIER M GHERARDI ” Practice Location

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