Individual
MAURA K GONCALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
395 ATWOOD AVE, CRANSTON, RI 02920-4358
(401) 464-9751
(401) 464-9755
Mailing address
442 HIGHLAND RD, TIVERTON, RI 02878-4429
(401) 297-6669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7639
MA
363A00000X
Physician Assistant
Primary
PA01255
RI
Other
Enumeration date
07/22/2020
Last updated
03/03/2023
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