Individual
JULIET PANICHELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 453-0120
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
LP06005
RI
2086S0122X
Plastic and Reconstructive Surgery Physician
LP06005
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
RI
Other
Enumeration date
05/22/2023
Last updated
06/23/2023
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