Provider Demographics
NPI:1740268622
Name:PINKES, VICTOR ALEXIS (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ALEXIS
Last Name:PINKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:135 LAUREL WOOD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1574
Mailing Address - Country:US
Mailing Address - Phone:401-398-1762
Mailing Address - Fax:401-767-1667
Practice Address - Street 1:495 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-493-4540
Practice Address - Fax:401-944-7727
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1539822083A0300X, 207P00000X
RI10635207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110058493AMedicaid