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Individual

MR. MICHAEL JOHN MARTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1145 RESERVOIR AVE, CRANSTON, RI 02920-6055
(401) 942-6500
Mailing address
1145 RESERVOIR AVE, CRANSTON, RI 02920-6055
(401) 942-6500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0144
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1275507
RI
Enumeration date
02/15/2006
Last updated
02/16/2026
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