Provider Demographics
NPI:1760622617
Name:HORRIGAN, LETITIA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:LETITIA
Middle Name:ANN
Last Name:HORRIGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 KINGSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3626
Mailing Address - Country:US
Mailing Address - Phone:401-789-0283
Mailing Address - Fax:401-789-0314
Practice Address - Street 1:481 KINGSTOWN RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3626
Practice Address - Country:US
Practice Address - Phone:401-789-0283
Practice Address - Fax:401-789-0314
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILH86230Medicaid
RI002373901Medicare PIN