Doctor Name: | DR. ROBERT EMMETT MCKITTRICK |
NPI Number: | 1356543466 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD 10184 RI |
Business Practice Address: | 495 Atwood Ave Cranston, RI - 029205316 |
Business Phone Number: | 4019434540 |
Business Fax Number: | |
Mailing Address: | 194 Waterman Lake Drive, GLOCESTER |
State: | RI |
Postal Code: | 02814 |
Phone Number: | 4014395961 |
Fax Number: | |
NPI Enumeration Date: | 06/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD 10184 RI |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |