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NPI Code Detail

MEDICARE: DR. STEPHANIE M PEDUTO M.D.

MEDICARE: DR. STEPHANIE M PEDUTO M.D.
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
1208000000XPediatrics PhysicianMD09602RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891790283
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE M PEDUTO M.D.
Provider Business Mailing Address
First Line : 2 MEEHAN LN
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1413
Country : US
Telephone Number : 401-658-2525
Fax Number : 401-658-3031
Provider Business Practice Location Address
First Line : 2 MEEHAN LN
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1413
Country : US
Telephone Number : 401-658-2525
Fax Number : 401-658-3031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 11/20/2013

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