Provider Demographics
NPI:1346269875
Name:NOWICK, ALAN R (DPM)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:NOWICK
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Gender:M
Credentials:DPM
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Mailing Address - Street 1:1681 CRANSTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5000
Mailing Address - Country:US
Mailing Address - Phone:401-943-1020
Mailing Address - Fax:401-943-9020
Practice Address - Street 1:1681 CRANSTON ST STE A
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5000
Practice Address - Country:US
Practice Address - Phone:401-943-1020
Practice Address - Fax:401-943-9020
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2023-03-01
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Provider Licenses
StateLicense IDTaxonomies
RIDPM00243213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T86835Medicare UPIN