Provider Demographics
NPI:1215920327
Name:FOOT AND ANKLE INSTITUTE OF NEW ENGLAND
Entity type:Organization
Organization Name:FOOT AND ANKLE INSTITUTE OF NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:GALLUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-738-7750
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:STE 503
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-738-7750
Mailing Address - Fax:401-738-9750
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:STE 503
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-738-7750
Practice Address - Fax:401-738-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIFA35314Medicaid
RI24240OtherNITP
RI21286-7OtherBCBS
RI24240OtherNITP
RIFA35314Medicaid