Individual
PATRICIA RYAN RECUPERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
JD, MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
MD07554
RI
2084P0800X
Psychiatry Physician
Primary
MD07554
RI
2084P0802X
Addiction Psychiatry Physician
MD07554
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
—
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
15-11140
UNITED BEHAVIORAL HEALTH
RI
01
—
200996
BLUE CHIP
RI
01
—
6481-5
BLUE CROSS
RI
Enumeration date
07/28/2006
Last updated
05/15/2008
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