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Individual

MICHELLE BORNSTEIN BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
175 NATE WHIPPLE HWY STE 102, CUMBERLAND, RI 02864-1422
(401) 334-5437
(401) 334-3571
Mailing address
175 NATE WHIPPLE HWY STE 102, CUMBERLAND, RI 02864-1422
(401) 334-5437
(401) 334-3571

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD12301
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD12301
STATE LICENSE NUMBER
RI
Enumeration date
05/10/2007
Last updated
02/17/2022
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