Individual
JEREMY DANIEL DIBIASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 AIRPORT RD, WARWICK, RI 02889-1001
(401) 606-2520
Mailing address
17 AIRPORT RD, WARWICK, RI 02889-1001
(401) 606-2520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN02742
RI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/19/2020
Last updated
09/09/2021
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