Provider Demographics
NPI:1194766402
Name:LAURA S NEVEL MD INC
Entity type:Organization
Organization Name:LAURA S NEVEL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARDENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-272-2562
Mailing Address - Street 1:725 RESERVOIR AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4448
Mailing Address - Country:US
Mailing Address - Phone:401-272-2562
Mailing Address - Fax:401-272-2805
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4448
Practice Address - Country:US
Practice Address - Phone:401-272-2562
Practice Address - Fax:401-272-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06338207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty