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NPI Code Detail

MEDICARE: DR. EVA KLONOWSKI MD

MEDICARE: DR. EVA KLONOWSKI 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
1207Q00000XFamily Medicine PhysicianMD05888RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
129044-5OTHERRIBLUE CROSS RI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
301-02592OTHERRIUNITED HEALTHCARE
4405882OTHERRIBLUE CHIP RI

General Provider Information

NPI Number : 1700837705
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVA KLONOWSKI MD
Provider Business Mailing Address
First Line : 1 RIVER ST.
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879
Country : US
Telephone Number : 401-783-0523
Fax Number : 401-783-9448
Provider Business Practice Location Address
First Line : 1 RIVER ST
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-3214
Country : US
Telephone Number : 401-783-0523
Fax Number : 401-783-9448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2006
Last Update Date : 07/08/2007

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Directions to “ DR. EVA KLONOWSKI MD” Practice Location

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