# JOHN MCGONIGLE MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396320057
- **Authorized official:** JOHN MCGONIGLE MD (PHYSICIAN/ OWNER)
- **Authorized official phone:** (401) 572-3300

## Contact information

- **Practice address:** 201 WATERMAN AVE, EAST PROVIDENCE, RI 02914-3522
- **Practice address phone:** (401) 572-3300
- **Practice address fax:** (401) 572-3301
- **Mailing address:** 201 WATERMAN AVE, EAST PROVIDENCE, RI 02914-3522
- **Mailing address phone:** (401) 572-3300
- **Mailing address fax:** (401) 572-3301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2021
- **Last updated:** 03/15/2021