Provider Demographics
NPI:1134195043
Name:REGINATO, ANTHONY M (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:REGINATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:375 WAMPANOAG TRAIL
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:E. PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02915
Mailing Address - Country:US
Mailing Address - Phone:401-649-4040
Mailing Address - Fax:401-649-4041
Practice Address - Street 1:375 WAMPANOAG TRAIL
Practice Address - Street 2:SUITE 202B
Practice Address - City:E. PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02915
Practice Address - Country:US
Practice Address - Phone:401-649-4040
Practice Address - Fax:401-649-4041
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2016-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA158176207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H38106Medicare UPIN