Provider Demographics
NPI:1467890780
Name:LABORISTS FOR OBSTETRICS & GYNECOLOGY, LLC
Entity Type:Organization
Organization Name:LABORISTS FOR OBSTETRICS & GYNECOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PULEO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-441-6405
Mailing Address - Street 1:1220 PONTIAC AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4457
Mailing Address - Country:US
Mailing Address - Phone:401-441-6405
Mailing Address - Fax:866-262-7397
Practice Address - Street 1:1220 PONTIAC AVE STE 302
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4457
Practice Address - Country:US
Practice Address - Phone:401-441-6405
Practice Address - Fax:866-262-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-08
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00579207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty