Provider Demographics
NPI:1548393408
Name:MARIA M. O'TOOLE, MD, LLC
Entity type:Organization
Organization Name:MARIA M. O'TOOLE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:O'TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-751-3330
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE LL6
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-751-3330
Mailing Address - Fax:401-274-1253
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE LL6
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-751-3330
Practice Address - Fax:401-274-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06049207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty