Provider Demographics
NPI:1770302242
Name:BONGIORNO, GLORIA (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:GLORIA
Middle Name:
Last Name:BONGIORNO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:RI
Mailing Address - Zip Code:02802-1112
Mailing Address - Country:US
Mailing Address - Phone:401-374-6534
Mailing Address - Fax:
Practice Address - Street 1:48 GASPEE POINT DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-4918
Practice Address - Country:US
Practice Address - Phone:401-996-5267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04300363L00000X
MARN2262916363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care