Provider Demographics
NPI:1790766517
Name:DIORIO, JOHN JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DIORIO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 TOLL GATE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4462
Mailing Address - Country:US
Mailing Address - Phone:401-467-9111
Mailing Address - Fax:401-461-1390
Practice Address - Street 1:215 TOLL GATE RD STE 106
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-467-9111
Practice Address - Fax:401-461-1390
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI5123207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI22682OtherBLUE CROSS BLUE SHIELD
RI000658OtherBLUECHIP
RI9001281Medicaid
E99911Medicare UPIN
RI9001281Medicaid