Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHANIKA PHORNPHUTKUL, MD
ActiveGeriatric Psychiatry · PROVIDENCE, RI
Registration Details
- NPI Number
- 1639124530
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 23, 2006 (19.914005651004 yrs)
- Last Updated
- Dec 21, 2011
- Licenses
-
10121 (RI)MD10121 (RI)
Practice Information
- Address
-
593 EDDY STPROVIDENCE, RI, 029034923Browse RI providers · Browse ZIP 02903
- Phone
- 4014448361
- Fax
- 4014443288
- Primary Specialty
-
Geriatric Psychiatry
207SG0202X
- Additional Specialty
- Geriatric Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.