Provider Demographics
NPI:1841407129
Name:WINTHROP, DEBORAH ANNE
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:WINTHROP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CLOCK TOWER SQ
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-1396
Mailing Address - Country:US
Mailing Address - Phone:401-682-2272
Mailing Address - Fax:401-682-2273
Practice Address - Street 1:103 CLOCK TOWER SQ
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-1396
Practice Address - Country:US
Practice Address - Phone:401-682-2272
Practice Address - Fax:401-682-2273
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410336OtherBLUE CHIP OF RI
RI050506167OtherTRI CARE
RI30774Medicaid
RI21501-9OtherBLUE CROSS OF RI
RI4426140001Medicare NSC