Provider Demographics
NPI:1720311087
Name:CIRESI, ANGELA ROSE (DC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE
Last Name:CIRESI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ROSE
Other - Last Name:CALIRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3285 SOUTH COUNTY TRAIL
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-855-0725
Mailing Address - Fax:
Practice Address - Street 1:3285 SOUTH COUNTY TRAIL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818
Practice Address - Country:US
Practice Address - Phone:401-855-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3590039631OtherMEDICARE