Organization
CAVICCHIO PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M CAVICCHIO DPM (OWNER)
(401) 312-9999
Entity
Organization
Contact information
Practice address
2 WAKE ROBIN RD, UNIT 203, LINCOLN, RI 02865-4295
(401) 312-9999
(401) 312-0416
Mailing address
2 WAKE ROBIN RD, UNIT 203, LINCOLN, RI 02865-4295
(401) 312-9999
(401) 312-0416
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
DPM 206
RI
213ES0131X
Foot Surgery Podiatrist
Primary
DPM 206
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000432
BLUE CHIP
RI
01
—
0475951001
CIGNA
RI
01
—
0536455
AETNA
RI
01
—
2700124
UNITED HEALTH CARE
RI
01
—
480001530
RAILROAD MEDICARE
RI
01
—
70366
BLUE CROSS BLUE SHIELD
RI
01
—
770036
BLUE CROSS BLUE SHIELD
MA
05
—
9007036
—
RI
01
—
P12001350
MULTIPLAN
RI
Enumeration date
08/01/2016
Last updated
08/01/2016
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