Provider Demographics
NPI:1104854595
Name:VOLLUCCI, CHRISTINE M (MS PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:VOLLUCCI
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
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Mailing Address - Street 1:37 ARCADIA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4601
Mailing Address - Country:US
Mailing Address - Phone:401-398-9447
Mailing Address - Fax:401-463-5808
Practice Address - Street 1:140 POINT JUDITH RD
Practice Address - Street 2:SUITE 47
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3477
Practice Address - Country:US
Practice Address - Phone:401-789-2077
Practice Address - Fax:401-782-4762
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPT01502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
406099OtherBLUE CHIP
290155OtherBLUE CROSS
RI007057641Medicare PIN