Organization
CENTER FOR PLASTIC AND HAND SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA A DICICCO (OFFICE MANAGER)
40163204702
Entity
Organization
Contact information
Practice address
235 PLAIN ST, SUITE 203, PROVIDENCE, RI 02905-3240
(401) 632-4700
(401) 632-4704
Mailing address
235 PLAIN ST, SUITE 203, PROVIDENCE, RI 02905-3240
(401) 632-4700
(401) 632-4704
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
RI 12444
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SS73819
—
RI
Enumeration date
11/17/2010
Last updated
11/17/2010
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