Individual
DR. AILIS CLYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 CENTERVILLE RD, THE SUMMIT EAST, SUITE 110, WARWICK, RI 02886-0200
(401) 615-2299
(401) 615-7529
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD09744
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070067252
MEDICARE
—
05
—
7006725
—
RI
Enumeration date
09/02/2005
Last updated
06/10/2016
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