Individual
ANTONIO EMMANUEL REISOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7 CENTRAL ST, PROVIDENCE, RI 02907-2201
(401) 648-4700
Mailing address
7 CENTRAL ST, PROVIDENCE, RI 02907-2201
(401) 648-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01470
RI
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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