Individual
MARIA A BERMUDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASST PAC
Contact information
Practice address
42 PARK PLACE, PAWTUCKET, RI 02860
(401) 729-0080
(401) 729-0438
Mailing address
72 MINERAL SPRING AVE APT 11, PAWTUCKET, RI 02860-2808
(401) 722-0569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00184
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30677
BC
—
01
—
404960
BCHIP
—
Enumeration date
07/13/2006
Last updated
06/01/2009
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