Provider Demographics
NPI:1457482820
Name:DELCUPOLO ABRAMOWITZ AND ASSOCIATES INC PC
Entity Type:Organization
Organization Name:DELCUPOLO ABRAMOWITZ AND ASSOCIATES INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELCUPOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:401-861-5600
Mailing Address - Street 1:16 BRIDGE ST
Mailing Address - Street 2:CORLISS LANDING
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-861-5600
Mailing Address - Fax:401-861-5603
Practice Address - Street 1:16 BRIDGE ST
Practice Address - Street 2:CORLISS LANDING
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-861-5600
Practice Address - Fax:401-861-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI020101223G0001X
RI024961223P0300X
RI027281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty