Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KYLE FREDERICK
Active2472E0500X · PROVIDENCE, RI
Registration Details
- NPI Number
- 1679089981
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 21, 2017 (8.3342663324029 yrs)
- Last Updated
- Dec 21, 2017
Practice Information
- Address
-
2 REGENCY PLZ STE 3PROVIDENCE, RI, 029033149Browse RI providers · Browse ZIP 02903
- Phone
- 4014841706
- Fax
- 4014376959
- Primary Specialty
-
2472E0500X
2472E0500X
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.