Provider Demographics
NPI:1972614733
Name:ALTONGY, GILBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:J
Last Name:ALTONGY
Suffix:
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:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:RI
Mailing Address - Zip Code:02802-0070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1002 BROAD STREET
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863
Practice Address - Country:US
Practice Address - Phone:401-723-9250
Practice Address - Fax:401-728-0301
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05204207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050415661OtherCIGNA
RI0400543OtherUNITED HEALTH
RI050415661OtherCOMM
RI050415661OtherMASHANTUCKET
RI050415661OtherAARP
RI404348OtherTUFTS
RI64933OtherHARVARD
RI9001353Medicaid
RI000150OtherCHIP
RI050415661OtherW/C
RI060000093OtherRR MEDICARE
RI13532OtherBLUE CROSS
RI5329228OtherAETNA
RI6284OtherNEIGHBORHOOD
RI7610758OtherN CAROLINA MEDICAID
RI404348OtherTUFTS