MICHELLE BERNICE RISTUCCIA (NPI# 1356789549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356789549 |
| Entity Type | Individual |
| Full Name | MICHELLE BERNICE RISTUCCIA |
| Credential | PA |
| Practice Address |
164 Summit Ave # C70 Providence RI 02906-2853 |
| Mailing Address |
Po Box 16149 Rumford RI 02916-0697 |
| Practice Telephone | 4017934545 |
| Practice Fax Number | 4017937866 |
| Mailing Telephone | 4014539625 |
| Mailing Fax Number | 4014357069 |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
164 SUMMIT AVE # C70 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457328221 | Richard A. Hernandez | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2006-03-01 |
| 1568072510 | Anthony Henriques | Nurse Practitioner | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2020-08-05 |
| 1356691430 | Kelvin Nam Doan | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2012-09-14 |
| 1467783357 | Karen M Doyle | Nurse Practitioner | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2010-01-18 |
| 1174586671 | Phathsady Louangxay | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2006-04-07 |
| 1972570182 | Pamela M Brissette | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356900591 | Ryan O'kelly | Physician Assistant | 285 Promenade St, Providence, RI 02908 | 2019-06-11 |
| 1558841999 | Lindsey Scherer | Physician Assistant | 825 Chalkstone Ave, Providence, RI 02908 | 2018-08-15 |
| 1134658339 | Kevin P Santilli | Physician Assistant | 593 Eddy St, Providence, RI 02903-4923 | 2017-06-09 |
| 1194260984 | Brittany Hogan | Physician Assistant | 593 Eddy St, 6th Floor, Providence, RI 02903-4923 | 2017-01-03 |
| 1356691430 | Kelvin Nam Doan | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2012-09-14 |
| 1588911457 | Britta Renzulli | Physician Assistant | 2 Dudley St, Suite 190, Providence, RI 02905-3236 | 2012-08-10 |
| 1174896211 | Stephanie Slone | Physician Assistant | 593 Eddy St, Providence, RI 02903-4923 | 2012-02-21 |
| 1316210545 | Peter Richard Mello | Physician Assistant | 118 Dudley St, Providence, RI 02905-2403 | 2012-02-19 |
| 1679844807 | Joseph Paul Paciello | Physician Assistant | 2 Dudley St, Providence, RI 02905-3236 | 2012-01-19 |
| 1023306156 | Linhuang Han | Physician Assistant | 593 Eddy St, Main 4, Providence, RI 02903-4923 | 2011-07-11 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
Please comment or provide details below to improve the information on MICHELLE BERNICE RISTUCCIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.