Maximilian Bonnici
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Woonsocket, RI
NPI 1285489476 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1285489476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 115 Cass Ave
Woonsocket, RI 02895-4731 - Phone
- (401) 769-4100
- NPI assigned
- Apr 22, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250203002335 | RI | Order and Referring Only - Internal Medicine |
4486184678 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
115 Cass Ave
Woonsocket, RI 02895-4731
Mailing address
115 Cass Ave
Woonsocket, RI 02895-4731
Phone (401) 769-4100
Other providers in Woonsocket, RI
- Judy H Bolzani
- Cynthia Marie Bonaldi
- Francisco Miguel Bonilla
- Julius John Bonner
- Jacques Bonnet-Eymard
- Thepdara Boriboun
- Christine Borino
- Jeannine Marie Borozny
- Jason David Boucher
- Monique Boudreau
All providers in Woonsocket, RI · Student in an Organized Health Care Education/Training Program in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.