Organization · Type 2 NPI

2 Dudley Street Operatory LLC

Plastic and Reconstructive Surgery Physician · Providence, RI

NPI number 1487761177 Active

Practice location

2 Dudley St, Suite 465
Providence, RI 02905-3236

Fax (401) 831-0647

Specialties and licenses

TaxonomyCodeLicense
Orthopaedic Surgery Physician 207X00000XNone listed
Plastic and Reconstructive Surgery Physician Primary 2086S0122XNone listed

Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.

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About NPI 1487761177

2 Dudley Street Operatory LLC's National Provider Identifier is 1487761177, issued on Aug 25, 2006. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Providence, RI. The record was last updated on Sep 11, 2025.