Provider Demographics
NPI:1023039740
Name:AUMENTADO, DENNIS JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOSEPH
Last Name:AUMENTADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 MENDON RD
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3927
Mailing Address - Country:US
Mailing Address - Phone:401-762-0170
Mailing Address - Fax:401-762-3774
Practice Address - Street 1:1065 MENDON RD
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3927
Practice Address - Country:US
Practice Address - Phone:401-762-0170
Practice Address - Fax:401-762-3774
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI79662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
202044OtherBLUECHIP
728570OtherTUFTS
E55631Medicare UPIN
728570OtherTUFTS