Provider Demographics
NPI:1821067372
Name:REIBMAN, BONNIE H (MD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:H
Last Name:REIBMAN
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 1:1377 S COUNTY TRL
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-5082
Mailing Address - Country:US
Mailing Address - Phone:401-884-8900
Mailing Address - Fax:401-884-9199
Practice Address - Street 1:1377 S COUNTY TRL
Practice Address - Street 2:SUITE 2B
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5082
Practice Address - Country:US
Practice Address - Phone:401-884-8900
Practice Address - Fax:401-884-9199
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD 10034208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0000023951OtherBC/BS-RI
RI2639251OtherAETNA/US HEALTHCARE
RIP2317736OtherOXFORD
RI05-0517985OtherTAX ID
RI047697OtherTUFTS
RI405465OtherBC/BS-RI BLUE CHIP
RI2465OtherNHP-RI
RI5118206OtherAETNA/ US HEALTHCARE
RI1553812OtherGHI HMO
RI419474OtherUSFHP
RIAA34536OtherHPHC
RI405465OtherBC/BS-RI BLUE CHIP