NPI 1639124530

Chanika Phornphutkul, MD

Practitioner Clinical Biochemical Genetics Physician Providence, RI

Practice location

Address: 593 Eddy St, Providence, RI 02903-4923
Phone: (401) 444-8361
Fax: (401) 444-3288
Mailing address: 593 Eddy St Hasbro 122, Providence, RI 02903-4923

Registered specialties (2)

Clinical Biochemical Genetics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207SG0202X Licence MD10121 (RI)

Other Medical Genetics providers in Rhode Island →

Pediatric Endocrinology Physician

Allopathic & Osteopathic Physicians Taxonomy 2080P0205X Licence 10121 (RI)

Other Pediatrics providers in Rhode Island →

Registry record

NPI: 1639124530
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 May 2006
Record last updated: 21 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.