Individual
MARY LEONA LUSSIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 WAMPANOAG TRL, STE 204, RIVERSIDE, RI 02915-2218
(401) 438-2400
(401) 438-2422
Mailing address
250 WAMPANOAG TRL, STE 204, RIVERSIDE, RI 02915-2218
(401) 438-2400
(401) 438-2422
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD08052
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500318
UNITED HEALTH CARE
—
01
—
050508380
HEALTHCARE VALUE MANAGEME
—
01
—
103941700
DEPT OF LABOR WORKERS COM
—
01
—
111055
HARVARD PILGRIM HEALTH CA
MA
01
—
139002880
MEDICARE PTAN
RI
01
—
2635
NEIGHBORHOOD HEALTH PLAN
RI
01
—
28808
BLUE CROSS BLUE SHIELD
RI
01
—
406525
BLUE CHIP
RI
01
—
8910896
CIGNA
—
05
—
9002880
—
RI
Enumeration date
11/21/2006
Last updated
08/30/2013
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