Provider Demographics
NPI:1770577298
Name:TERLATO, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:TERLATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:900 WARREN AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:800-508-4908
Practice Address - Fax:401-228-6236
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD08852207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI20242OtherBCBS OF RI
RI709004155OtherMEDICARE GROUP
RI9020242Medicaid
RI050483739OtherGREAT WEST HEALTH CARE
RI204531OtherBLUE CHIP
RI23677OtherNEIGHBORHOOD HEALTH PLAN
RI710034001OtherCIGNA
RI060032059OtherRAILROAD MEDICARE
RI64915OtherHARVARD HEALTH PLAN
RI25-00265OtherUNITED HEALTH CARE
RI404461OtherTUFTS HEALTH PLAN
RI25-00265OtherUNITED HEALTH CARE
RI060032059OtherRAILROAD MEDICARE
RI007057719Medicare ID - Type Unspecified