IndividualActive
Joseph Dibernardo, PA-C
NPI 1497721419 · Medical Physician Assistant · Providence, RI
Provider details
- NPI number
- 1497721419
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00321 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
164 Summit Ave # C70
Providence, RI 02906-2853
Phone: (401) 793-4545
Fax: (401) 793-7866
Approximate (ZIP-level) locationGet directions
Mailing address
15 Lasalle Square
Providence, RI 02903
Additional practice locations (1)
- 455 Toll Gate RdWarwick, RI 02886-2770Phone: (401) 737-7010Fax: (401) 736-4546
Registry dates
- Enumerated
- 2006-02-28
- Last updated
- 2025-12-02
- Certified
- 2025-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.