Provider Demographics
NPI:1700874690
Name:CONTE, LUZVIMINDA (PA)
Entity type:Individual
Prefix:
First Name:LUZVIMINDA
Middle Name:
Last Name:CONTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LUZVIMINDA
Other - Middle Name:
Other - Last Name:SOUNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 16149
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-0697
Mailing Address - Country:US
Mailing Address - Phone:401-453-9625
Mailing Address - Fax:401-435-7069
Practice Address - Street 1:2 DUDLEY ST STE 470
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3248
Practice Address - Country:US
Practice Address - Phone:401-553-8320
Practice Address - Fax:401-868-2322
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA00189363A00000X
RIPA00189363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
408927OtherBLUECHIP
302759OtherBLUESHIELD
970022493OtherRAILROAD MEDICARE
7009176OtherRIMEDICAL ASSISTANCE
007009177OtherHOSPITALPIN