Individual
NICOLE M ABRUNZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 854-2504
(401) 854-2519
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
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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