Provider Demographics
NPI:1942220850
Name:URIAN, KILEEN S (PT)
Entity Type:Individual
Prefix:
First Name:KILEEN
Middle Name:S
Last Name:URIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2917
Mailing Address - Country:US
Mailing Address - Phone:401-884-1177
Mailing Address - Fax:401-884-8697
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-884-9840
Practice Address - Fax:401-884-8697
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI01800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26729OtherBLUE CHIP
RI007050103Medicare ID - Type Unspecified