Provider Demographics
NPI:1437322427
Name:STARKENBERG, AMY J (NPP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:STARKENBERG
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 MENDON RD
Mailing Address - Street 2:STE 1
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3833
Mailing Address - Country:US
Mailing Address - Phone:401-475-3000
Mailing Address - Fax:401-475-0875
Practice Address - Street 1:2140 MENDON RD
Practice Address - Street 2:STE 1
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3833
Practice Address - Country:US
Practice Address - Phone:401-475-3000
Practice Address - Fax:401-475-0875
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine