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Individual

MRS. DOROTHY LORRAINE DELESSIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CDOE, CDE

Contact information

Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 729-2759
(401) 729-2923
Mailing address
111 BREWSTER ST, DEPARTMENT OF FAMILY MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-2759
(401) 729-2923

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN00127
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007056708
MEDICARE PTAN
RI
Enumeration date
05/12/2006
Last updated
11/24/2010
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