Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Penvose

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629658943

Ian Penvose is a Student in an Organized Health Care Education/Training Program in Providence, Rhode Island. Practices as a sole proprietor. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

593 Eddy St
Providence, RI 02903
Phone: (401) 444-4030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence LP05576 (RI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence LP05576 (RI)

Record details

NPI number1629658943
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 12, 2021
Last updated in NPPESJune 30, 2023
Certification dateJune 30, 2023
Mailing address593 Eddy Street, Providence, RI 02903

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