Individual
EDWARD J. MARCACCIO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 DUDLEY ST, SUITE 470, PROVIDENCE, RI 02905-3236
(401) 553-8318
(401) 868-2307
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD08399
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3089657
—
MA
05
—
7003376
—
RI
Enumeration date
07/12/2005
Last updated
07/12/2024
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