Provider Demographics
NPI:1912972324
Name:KAPOOR, NIDHI (MD)
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:KAPOOR
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 1:506 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3531
Mailing Address - Country:US
Mailing Address - Phone:401-270-3998
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:55 CLAVERICK 2ND FLOOR
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-5210
Practice Address - Fax:401-444-2307
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11163207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912972324OtherNPI
RI27420-3OtherBLUECROSS BLUESHIELD
RI7010525Medicaid
H16813Medicare UPIN