Provider Demographics
NPI:1639185689
Name:MARCACCIO, BETH GERFIN (MD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:GERFIN
Last Name:MARCACCIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-384-6444
Mailing Address - Fax:401-384-6294
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 508
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-384-6444
Practice Address - Fax:401-384-6294
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RI10511207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E69850Medicare UPIN