Provider Demographics
NPI:1508011420
Name:BEN TRE, GAY B (DAC, RN)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:B
Last Name:BEN TRE
Suffix:
Gender:F
Credentials:DAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 FRIENDSHIP ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2200
Mailing Address - Country:US
Mailing Address - Phone:401-324-6061
Mailing Address - Fax:401-324-6062
Practice Address - Street 1:19 FRIENDSHIP ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2200
Practice Address - Country:US
Practice Address - Phone:401-324-6061
Practice Address - Fax:401-324-6062
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN21292163W00000X
RIDA00239171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse