Provider Demographics
NPI:1750585295
Name:ASSOCIATES IN PODIATRY INCORPORATED
Entity type:Organization
Organization Name:ASSOCIATES IN PODIATRY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM FAC FAS
Authorized Official - Phone:401-885-6090
Mailing Address - Street 1:1050 MAIN ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3161
Mailing Address - Country:US
Mailing Address - Phone:401-885-6090
Mailing Address - Fax:401-885-6091
Practice Address - Street 1:1050 MAIN ST
Practice Address - Street 2:SUITE 21
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3161
Practice Address - Country:US
Practice Address - Phone:401-885-6090
Practice Address - Fax:401-885-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM247213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1099OtherCIGNA
RI5717213OtherAETNA
RI9007078Medicaid
RIBLUE CROSS BLUE SHOtherBLUE CROSS
RI000000001099OtherNHPRI
RI004604OtherBLUE CHIP
RI2700181OtherUNITED HEALTH
RI9007078Medicaid