BLACKSTONE VALLEY FOOT AND ANKLE INC. (NPI# 1720482193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720482193 |
| Entity Type | Organization |
| Organization Name | BLACKSTONE VALLEY FOOT AND ANKLE INC. |
| Practice Address |
345 Armistice Blvd Pawtucket RI 02861-2429 |
| Practice Telephone | 4017255576 |
| Practice Fax Number | 4017252640 |
| Mailing Telephone | 4017255576 |
| Mailing Fax Number | 4017252640 |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2017-04-24 |
| Authorized Official Name | DR. JOSEPH KEVIN DOMENICO (OWNER) |
| Authorized Official Telephone | 4017255576 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DPM00327 | RI | Podiatric Medicine & Surgery Service Providers |
| Street Address |
345 ARMISTICE BLVD |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02861-2429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023132099 | Melvin J Mancini | Podiatrist | 345 Armistice Blvd, Pawtucket, RI 02861-2429 | 2007-03-16 |
| 1609056712 | Melvin J Mancini Dpm | Podiatrist | 345 Armistice Blvd, Pawtucket, RI 02861-2429 | 2007-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525209 | Brianna Laurila | Dietitian, Registered | 541 Cottage Street, Pawtucket, RI 02861 | 2016-09-01 |
| 1790056430 | Matthew J Lavoie | Physician Assistant | 70 Gill Ave., Pawtucket Center, Genesis Health Care, Pawtucket, RI 02861 | 2012-01-25 |
| 1356359293 | Anita N Vasvani | Dentist | 140 Newport Ave, Pawtucket, RI 02861 | 2006-08-04 |
| 1548294408 | Stop and Shop Supermarket Co LLC | Pharmacy | 368398 Cottage Street, Pawtucket, RI 02861 | 2006-07-10 |
| 1154363695 | Levis M Guzman | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861 | 2006-06-11 |
| 1265938179 | Modern Eyes LLC | Optometrist | 145 Newport Ave, Pawtucket, RI 02861 | 2018-04-01 |
| 1942313929 | Abbas Ghorieshi | Dentist | 115 Newport Ave, Pawtucket, RI 02861 | 2006-08-16 |
| 1114499506 | Arts, Sports, and Technology Resource Organization | Poetry Therapist | 175 Coyle Ave, Pawtucket, RI 02861-1007 | 2018-12-22 |
| 1235600255 | Abdoulaye Soumahoro | Driver | 68 Webster St, Pawtucket, RI 02861-1016 | 2018-12-17 |
| 1376761544 | Professional Internal Medicine Associates Inc | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861-1024 | 2007-04-23 |
| Find all providers in zip 02861 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134242472 | Rhode Island Foot Care, Inc | Podiatrist | 649 East Ave, Pawtucket, RI 02860-6157 | 2007-04-10 |
| 1023132099 | Melvin J Mancini | Podiatrist | 345 Armistice Blvd, Pawtucket, RI 02861-2429 | 2007-03-16 |
| 1003982547 | Heritage Medical Associates PC | Podiatrist | 131 Beechwood Ave, Pawtucket, RI 02860-5409 | 2006-11-27 |
| 1245247089 | William S Naughton | Podiatrist | 524 Central Ave, Pawtucket, RI 02861-1947 | 2006-08-02 |
| 1225551187 | Michal Marcin Szpara | Podiatrist | 111 Brewster St, Pawtucket, RI 02860-4474 | 2017-07-24 |
| 1770005951 | Matthew W Lawrence | Podiatrist | 111 Brewster St, Pawtucket, RI 02860-4474 | 2017-07-10 |
| 1013323419 | Ashley Nancy Mastrangelo | Podiatrist | 111 Brewster St, Pawtucket, RI 02860-4474 | 2014-07-07 |
| 1710280037 | James Frederic Appleton Jr. | Podiatrist | 649 East Ave, Pawtucket, RI 02860-6157 | 2010-12-08 |
| 1609056712 | Melvin J Mancini Dpm | Podiatrist | 345 Armistice Blvd, Pawtucket, RI 02861-2429 | 2007-11-06 |
| 1346366622 | New England Foot and Ankle Associates, PC | Podiatrist | 407 East Ave, Suite 120, Pawtucket, RI 02860-5299 | 2007-03-21 |
| 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.