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Individual

BRIAN F PONTARELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
486 SILVER SPRING ST, PROVIDENCE, RI 02904
(401) 751-2660
(401) 751-9990
Mailing address
250 WAMPANOAG TRAIL, SUITE 205 RHODE ISLAND FOOT CARE INC, EAST PROVIDENCE, RI 02915
(401) 431-0283
(401) 438-5956

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM00294
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7007118
RI
Enumeration date
11/03/2006
Last updated
02/07/2008
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