Individual
ELISA SEMEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
21 DIVISION ST, PAWTUCKET, RI 02860-5352
(401) 726-7100
(401) 721-5214
Mailing address
4 RICHMOND SQ STE 200, PROVIDENCE, RI 02906-5117
(401) 433-4172
(401) 433-0612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1311010
TX
225100000X
Physical Therapist
Primary
PT02428
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PENDING
RI
Enumeration date
06/27/2011
Last updated
06/02/2022
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