Individual
JOSE M RENGIFO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, BUTLER HOSPITAL, PROVIDENCE, RI 02906-4800
(401) 455-6655
Mailing address
345 BLACKSTONE BLVD, BUTLER HOSPITAL, PROVIDENCE, RI 02906-4800
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
CMD15380
RI
Other
Enumeration date
03/27/2012
Last updated
01/18/2017
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