MEDICARE: DR. CHRISTOPHER W LEY 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	207R00000X	Internal Medicine Physician	MD06618	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	709003711	OTHER	RI	GROUP MEDICARE
2	110039297	OTHER	RI	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	26-4839161	OTHER	RI	TAX ID

General Provider Information

NPI Number	:	1598752024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER W LEY MD

Provider Business Mailing Address
First Line	:	148 W RIVER ST
Second Line	:	SUITE 22B
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-2615
Country	:	US
Telephone Number	:	401-572-3887
Fax Number	:	401-865-6192

Provider Business Practice Location Address
First Line	:	148 W RIVER ST
Second Line	:	SUITE 22B
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-2615
Country	:	US
Telephone Number	:	401-572-3887
Fax Number	:	401-865-6192

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/07/2009

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