Organization · NPI-2

Agape Primary Care And Laser Center LLC

Internal Medicine · Providence, RI

NPI number1235305871
StatusActive
Last updated in NPPESJun 3, 2008

Details

NPI
1235305871
Entity type
Organization (NPI-2)
Legal business name
Agape Primary Care And Laser Center LLC
Organization subpart
No
Enumeration date
May 4, 2008
Last updated
Jun 3, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineMD08003RIYes
207N00000X DermatologyMD10894RI

Practice location

1195 N Main St
Providence, RI 02904-1824

Phone 401-654-4433

Mailing address

1195 N Main St
Providence, RI 02904-1824

Phone 401-654-4433

Authorized official

Frank Michael D'Alessandro
Owner/Director
4016544433

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