Individual
ALEKO KIMBOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906
(401) 793-4102
Mailing address
117 ELLENFILED STREET, SUITE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA01159
RI
Other
Enumeration date
06/29/2009
Last updated
10/03/2019
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