Provider Demographics
NPI:1073549259
Name:ANDRIULLI, GERARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:
Last Name:ANDRIULLI
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 1:2 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1600
Mailing Address - Country:US
Mailing Address - Phone:401-246-1195
Mailing Address - Fax:401-246-1985
Practice Address - Street 1:2 OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1602
Practice Address - Country:US
Practice Address - Phone:401-246-1195
Practice Address - Fax:401-246-1985
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD074192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI15-16207OtherUNITED BEHAVIORAL HEALTH
RI406535OtherBLUE CHIP
RIGA33826Medicaid
RI260047476OtherMEDICARE R R
RI30836-8OtherBLUE CROSS
RI260047476OtherMEDICARE R R
RI007008547Medicare ID - Type Unspecified