MR. RICHARD P IACOBUCCI


Address: 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451
Phone: 4018294446

MR. RICHARD P IACOBUCCI (NPI# 1760578132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760578132
Entity Type Individual
Full Name MR. RICHARD P IACOBUCCI
Credential MD
Practice Address 725 Reservoir Ave Ste 103
Cranston
RI 02910-4451
Mailing Address 1635 Mineral Spring Avenue
Ste # 200
North Providence
RI 02904
Practice Telephone 4018294446
Practice Fax Number 4018294434
Mailing Telephone 4013534936
Mailing Fax Number 4012703304
Enumeration Date 2006-10-05
Last Update Date 2019-02-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine RI4390 RI Allopathic & Osteopathic Physicians
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
RI4390 RI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
RI 9002331 05
BCBS 23317 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
1635 Mineral Spring Avenue, Ste # 200, North Providence, RI 02904 4013534936 4012703304

Office Location

Street Address 725 RESERVOIR AVE STE 103
City CRANSTON
State RI
Zip Code 02910-4451

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710098249 Ralph F Santoro Internal Medicine 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2006-08-31
1891336293 Erica Kristen Ogni Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2019-10-07
1215286984 Emily Diniz Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2012-09-10
1629370309 Kathleen L. Knowlton Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910 2010-12-01
1184877953 Tomoko Snyder Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2008-10-24
1871645341 Deirdre Odelia Couture Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2007-01-17
1144377755 Minh Huong Mary Fay Nurse Practitioner 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2007-01-04
1881754281 Shahzad Khurshid Internal Medicine 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 2006-12-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417443441 Luis Guzman Durable Medical Equipment & Medical Supplies 29 Rolfe Square, Cranston, MA 02910 2018-07-02
1023535010 Sarah Pagliarini Nurse Practitioner 725 Reservoir Ave Ste 308, Cranston, RI 02910 2017-08-29
1861890105 Marissa Falco Counselor 1471 Elmwood Avenue, Cranston, RI 02910 2014-12-19
1952702425 Lauren Beth Shibley Counselor 825 Pontiac Avenue Apt 14101, Cranston, RI 02910 2014-09-15
1831516632 Kelly Kilmartin Counselor 471 Elmwood Avenue, Cranston, RI 02910 2014-03-19
1376784827 Michael Eric Schaffer Counselor 989 Reservoir Ave Ste 104, Cranston, RI 02910 2009-03-13
1639384829 Dolores Maiello Ciambrone Social Worker 145 Harmon Ave, Cranston, RI 02910 2007-05-11
1750502241 Mary Jane Boucher Counselor Codac Cranston, 1052 Park Ave, Cranston, RI 02910 2007-05-01
1134250715 Michele Bailey Chaudhry Social Worker 935 Reservoir Ave, Cranston, RI 02910 2007-03-08
1487703658 Karen M Mega Dentist 567 Reservoir Ave, Cranston, RI 02910 2007-01-09
Find all providers in zip 02910

Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790974095 Patrick J. Brannon, Md, Ltd Internal Medicine 725 Reservoir Ave, Suite 204, Cranston, RI 02910-4448 2007-10-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1336381904 Michael Wu Internal Medicine 950 Warren Ave Ste 201, East Providence, RI 02914-1432 2009-03-29
1902052558 T.w. Tschirley Md Inc Internal Medicine 1524 Atwood Ave Ste 434, Johnston, RI 02919-3228 2008-08-14
1427210251 John Rodriguez Internal Medicine 68 Cumberland St Ste 103, Woonsocket, RI 02895 2008-07-02
1689836371 Katharine A. French Internal Medicine 950 Warren Ave Fl 2, East Providence, RI 02914-1432 2008-06-25
1265621460 Gideon Koren Internal Medicine Rih, 1 Hoppin Street, Providence, RI 02903 2007-10-24
1134315567 David B Pomfret Internal Medicine 20 Grey Gull Rd, Jamestown, RI 02835-2808 2007-09-19
1679792865 Kenneth Baxter Nanian Internal Medicine 201 Tanglewood Dr, East Greenwich, RI 02818-2215 2007-04-25
1417085622 Laboratorio Cardiovascular De P.r. Internal Medicine 391 Sargento Luis Medina Street, La Merced, San Juan, RI 00918 2007-03-01
1003921693 Mario Tami Internal Medicine 1264 Smith St, Providence, RI 02908 2006-08-21
1205942646 David J Fortunato Internal Medicine 75 S Union St, Unit 406, Pawtucket, RI 02860-3978 2006-08-21
Find all providers with the same taxonomy

Competitor

Search similar providers

City CRANSTON
Zip Code 02910

Improve Information

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Dataset Information

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.

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