Organization
LOUIS A FRAGOLA JR MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS A FRAGOLA JR. MD (PRESIDENT)
(401) 433-4851
Entity
Organization
Contact information
Practice address
1525 WAMPANOAG TRAIL, EAST PROVIDENCE, RI 02915
(401) 433-4851
(401) 433-3650
Mailing address
1525 WAMPANOAG TRAIL, EAST PROVIDENCE, RI 02915
(401) 433-4851
(401) 433-3650
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
RI4166
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000823
BLUE CHIP
RI
01
—
5292
BLUE CROSS
RI
05
—
9000529
—
RI
Enumeration date
03/06/2007
Last updated
08/22/2020
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