Provider Demographics
NPI:1942647276
Name:CANCIAN, MADELINE JONES (MD)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:JONES
Last Name:CANCIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:DOROTHY
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 NEWMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-3603
Mailing Address - Country:US
Mailing Address - Phone:401-854-2428
Mailing Address - Fax:401-868-2385
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY BLDG 14
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-453-6600
Practice Address - Fax:401-435-6694
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD16744208800000X
RILP02715208600000X, 208800000X
GA079693208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery