Individual
KRISTINA MARIE DUARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 RANDALL SQ, PROVIDENCE, RI 02904
(401) 274-6339
(401) 456-6290
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
204590
MA
207Q00000X
Family Medicine Physician
Primary
MD09763
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007059638
MEDICARE PTAN
RI
05
—
9022202
—
RI
Enumeration date
03/08/2006
Last updated
12/15/2023
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