Dianne Abuelo, MD

Individual provider Active NPI Pediatrics Physician · Providence, RI

NPI 1205889367 · NPPES record last updated Jan 21, 2011

Key facts

NPI
1205889367
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
05091 (RI)
Practice address
593 Eddy St
Pob 234
Providence, RI 02903-4923
Phone
(401) 444-8361
Fax
(401) 444-3288
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05091RIMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 05091 RI Yes

Addresses

Primary practice location

593 Eddy St
Pob 234
Providence, RI 02903-4923

Mailing address

593 Eddy St
Pob 234
Providence, RI 02903-4923
Phone (401) 444-8484

Other identifiers

IdentifierTypeStateIssuer
9006052MedicaidRI

Other providers in Providence, RI

All providers in Providence, RI · Pediatrics Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.