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Individual

NICOLE M ABRUNZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-114235
IL
208000000X
Pediatrics Physician
Primary
MD12710
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007060380
RI MEDICARE
RI
05
036114235
IL
01
04/15/2009
UNITED HEALTHCARE
RI
01
12/29/2008
TUFTS HEALTH PLAN
MA
01
1336194794
NPI
RI
01
1992758544
CMMG GROUP NPI
IL
05
2159287
MA
01
9/11/2008
NHPRI
RI
05
NA72114
RI
Enumeration date
05/24/2006
Last updated
09/17/2013
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