| Knightsville Internal Medicine | |
|
1681 Cranston St Suite D Cranston RI 02920-5000 | |
| (401) 946-8446 | |
| (401) 946-8340 |
| Full Name | Knightsville Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 1681 Cranston St, Cranston, Rhode Island |
| Authorized Official Name and Position | Frank P Maggiacomo (PRESIDENT) |
| Authorized Official Contact | 4019468446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Knightsville Internal Medicine 1681 Cranston St Suite D Cranston RI 02920-5000 Ph: (401) 946-8446 | Knightsville Internal Medicine 1681 Cranston St Suite D Cranston RI 02920-5000 Ph: (401) 946-8446 |
| NPI Number | 1124217674 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 10/22/2007 |
| Medicare PECOS PAC ID | 4587609664 |
|---|---|
| Medicare Enrollment ID | O20100721000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124217674 | NPI | - | NPPES |
| 119003084 | Other | RI | PTAN |
| FM27448 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | DO 00383 (Rhode Island) | Primary |
| Provider Name | Luann M Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497811707 PECOS PAC ID: 5395755326 Enrollment ID: I20060504000407 |
| Provider Name | Frank Maggiacomo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629075981 PECOS PAC ID: 6103958517 Enrollment ID: I20100721000383 |
| Provider Name | Anthony E Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164470332 PECOS PAC ID: 9234144130 Enrollment ID: I20231009003125 |
Fallon & Horan Do Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1592 Broad St, Cranston, RI 02905 Phone: 401-467-3350 | |
Park Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 Park Ave, Cranston, RI 02905 Phone: 800-927-0002 | |
Roberto Ortiz M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 925 Reservoir Ave, Cranston, RI 02910 Phone: 401-943-9791 Fax: 401-943-1071 | |
Medicine And Long Term Care Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 333 Budlong Rd, Cranston, RI 02920 Phone: 401-943-4530 | |
Kardous Primary Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1145 Reservoir Ave, Ste 301, Cranston, RI 02920 Phone: 401-946-5001 Fax: 401-946-5101 | |
Leonard A Mannarelli Ii, D.o. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 Atwood Ave, Cranston, RI 02920 Phone: 401-944-1748 Fax: 401-944-1746 |