LAURALYN B. CANNISTRA (NPI# 1467413898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467413898 |
| Entity Type | Individual |
| Full Name | LAURALYN B. CANNISTRA |
| Credential | MD |
| Practice Address |
131 Beechwood Avenue Pawtucket RI 02860 |
| Practice Telephone | 4014751999 |
| Practice Fax Number | 4014756932 |
| Mailing Telephone | (401) 475-1999 |
| Mailing Fax Number | 4014756932 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
75195 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD08607 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 9006817 | 05 | |
| RI | MEDICARE PTAN | 007057418 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 75 Francis St, Boston, MA 021156110 | 8573074000 |
| Street Address |
131 BEECHWOOD AVENUE |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497743330 | John P Miskovsky | Internal Medicine | 131 Beechwood Avenue, Pawtucket, RI 02860 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205942646 | David J Fortunato | Internal Medicine | 75 S Union St, Unit 406, Pawtucket, RI 02860-3978 | 2006-08-21 |
| 1407854797 | Alice Yang-hee Kim | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2005-07-11 |
| 1194912527 | Blackstone Cardiology Associates, PC | Internal Medicine | 333 School St, Suite 112, Pawtucket, RI 02860-5334 | 2007-10-01 |
| 1902026701 | Memorial Hospital | Internal Medicine | 111 Brewster St, Pawtucket, RI 02860-4400 | 2007-04-26 |
| 1841318367 | Lgln Cardiology Consultants,llc | Internal Medicine | 407 East Avenue, Suite 130, Pawtucket, RI 02860 | 2007-03-26 |
| 1891834958 | Christopher J Luttmann | Internal Medicine | 407 East Ave, Suite 130, Pawtucket, RI 02860-5290 | 2007-02-05 |
| 1134268287 | Andrew A Nowak | Internal Medicine | 407 East Ave, Suite 130, Pawtucket, RI 02860-5290 | 2007-02-05 |
| 1902945058 | Jon K Lambrecht | Internal Medicine | 407 East Ave, Suite 130, Pawtucket, RI 02860-5290 | 2007-02-05 |
| 1558416040 | Suhdong Hahn | Internal Medicine | 333 School St, Suite 107, Pawtucket, RI 02860-5334 | 2007-01-24 |
| 1124101340 | Blackstone Cardiology Associates | Internal Medicine | 333 School Street, Ste 112, Pawtucket, RI 02860-5336 | 2006-10-23 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.