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

Kenneth Elad Fonguck

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1265028781

Kenneth Elad Fonguck is a Psychiatric/Mental Health Nurse Practitioner in Woonsocket, Rhode Island. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2020

Practice location Address checks out

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone: (402) 419-6291
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN-NP296175 (GA)

Record details

NPI number1265028781
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 18, 2020
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026

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