Individual
DAVID A. DICECCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HIGH SERVICE AVENUE, MARION HALL, 2ND FLOOR, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3456
(401) 456-3458
Mailing address
200 HIGH SERVICE AVENUE, MARIAN HALL, 2ND FLOOR, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3456
(401) 456-3458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6289
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000415
—
RI
Enumeration date
08/31/2006
Last updated
05/03/2012
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