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Individual

SUSAN L PAKULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 COMMERCE ST, PEDIATRICS, LINCOLN, RI 02865-1168
(401) 793-8484
(401) 793-8481
Mailing address
1 COMMERCE ST, PEDIATRICS, LINCOLN, RI 02865-1168
(401) 793-8484
(401) 793-8481

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD05525
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2067871
MA
05
7003061
RI
Enumeration date
06/27/2005
Last updated
07/21/2008
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