Provider Demographics
NPI:1447217641
Name:LADETTO, JOHN V (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:LADETTO
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 1:73 BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5409
Mailing Address - Country:US
Mailing Address - Phone:401-724-4040
Mailing Address - Fax:
Practice Address - Street 1:375 WAMPANOAG TRL STE 302B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2235
Practice Address - Country:US
Practice Address - Phone:401-649-4070
Practice Address - Fax:401-649-4071
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161008207RP1001X
RIMD09817207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease