Provider Demographics
NPI:1275692493
Name:LECONTE, CARINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARINE
Middle Name:M
Last Name:LECONTE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1150 RESERVOIR AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6068
Mailing Address - Country:US
Mailing Address - Phone:401-943-9222
Mailing Address - Fax:401-943-9290
Practice Address - Street 1:1150 RESERVOIR AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6068
Practice Address - Country:US
Practice Address - Phone:401-943-9222
Practice Address - Fax:401-943-9290
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RI08506208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIF91953Medicare UPIN