Provider Demographics
NPI:1598855348
Name:GABRIELE PERILLI, ANN ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:ROSE
Last Name:GABRIELE PERILLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 STAGECOACH RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6154
Mailing Address - Country:US
Mailing Address - Phone:401-738-3100
Mailing Address - Fax:401-738-8505
Practice Address - Street 1:455 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2759
Practice Address - Country:US
Practice Address - Phone:401-738-3100
Practice Address - Fax:401-738-8505
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD075232085B0100X, 2085N0700X, 2085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1178-5OtherBCBS TGR OFFICE
RI1570-5OtherBCBS TGR KENT
RI005238OtherTGR BLUE CHIP
RI7001823Medicaid
RI7001823Medicaid