Provider Demographics
NPI:1427081140
Name:MARSHA FITTRO PC,INC.
Entity type:Organization
Organization Name:MARSHA FITTRO PC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITTRO
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN,BC,CDOE
Authorized Official - Phone:401-435-5128
Mailing Address - Street 1:184 WAMPANOAG TRL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:184 WAMPANOAG TRL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2206
Practice Address - Country:US
Practice Address - Phone:401-435-5128
Practice Address - Fax:401-270-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI14926163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29238-2OtherBCBSOFRI
RI30333OtherNEIGHBORHOOD HEALTH
RI11450254OtherUNITED HEALTHCARE OF RI