Provider Demographics
NPI:1194013177
Name:CIANO, BRAD MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:MICHAEL
Last Name:CIANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 CRANSTON ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5104
Mailing Address - Country:US
Mailing Address - Phone:401-946-9933
Mailing Address - Fax:
Practice Address - Street 1:1591 CRANSTON ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5104
Practice Address - Country:US
Practice Address - Phone:401-946-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILPR00105213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist