| NPI | 1144773623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES M CAVICCHIO Owner 401-312-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: RI DPM 206) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: RI DPM 206) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |