Individual
J GARY ABUELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 WAMPANOAG TRL, SUITE 302A, RIVERSIDE, RI 02915-2232
(401) 649-4060
(401) 649-4061
Mailing address
17 VIRGINIA AVE, SUITE 107, PROVIDENCE, RI 02905-4406
(401) 443-4992
(401) 784-4902
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD04807
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390006588
RAILROAD MEDICARE
RI
05
—
6173721
—
MA
05
—
9001946
—
RI
Enumeration date
05/16/2006
Last updated
09/12/2016
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