Jack R Bevivino in Providence - Plastic Surgery
Jack R Bevivino - NPI 1780705707
Jack R Bevivino is a Plastic Surgery in Providence, Rhode Island. Jack R Bevivino practices all healthcare services and medical treatments related to Plastic Surgery. The NPI Number for Jack R Bevivino is 1780705707. The last update date is 2007-07-08.
Jack R Bevivino's current location address is 120 Dudley Street, Providence, Rhode Island. You can contact this provider via phone number 4015219290 and fax number 4015219297. The mailing address for Jack R Bevivino is 120 Dudley Street, Providence, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack R Bevivino |
|---|---|
| Address | 120 Dudley Street, Providence, Rhode Island |
| Phone Number | 4015219290 |
| Fax Number | 4015219297 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1780705707 |
|---|---|
| Provider Enumeration Date | 2007-04-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 120 Dudley Street |
|---|---|
| City | Providence |
| State | Rhode Island (RI) |
| Post Code | 29052431 |
| Phone Number | 4015219290 |
| Fax Number | 4015219297 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic Surgery |
|---|---|
| Taxonomy | 208200000X |
| Licence No | RIMD05259 |
|
Definition: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or c |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1300124 | RI | UNITED HEALTH CARE | |
| 9002112 | RI | -- | |
| 21126 | RI | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to Jack R Bevivino by the Centers for Medicare & Medicaid Services?
The Jack R Bevivino has been assigned the NPI (National Provider Identifier) 1780705707. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Jack R Bevivino located?
The Jack R Bevivino is located at 120 Dudley Street, Providence, RI 29052431.
What is Jack R Bevivino's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jack R Bevivino is Plastic Surgery, and the taxonomy classification code that categorizes this area of expertise is 208200000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1780705707 to Jack R Bevivino?
The Jack R Bevivino received its 1780705707 assignment from the Centers for Medicare & Medicaid Services on 2007-04-03.
As of what date were the details related to Jack R Bevivino most recently updated or revised?
The information pertaining to Jack R Bevivino, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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