Provider Demographics
NPI:1215944830
Name:WOLD, PATRICIA NEELY (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:NEELY
Last Name:WOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HIGH HAWK RD
Mailing Address - Street 2:
Mailing Address - City:E GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1317
Mailing Address - Country:US
Mailing Address - Phone:401-885-0258
Mailing Address - Fax:
Practice Address - Street 1:355 THAYER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1550
Practice Address - Country:US
Practice Address - Phone:401-331-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI36552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry