Provider Demographics
NPI:1679929814
Name:LAMBA, PEROLA (MD)
Entity type:Individual
Prefix:DR
First Name:PEROLA
Middle Name:
Last Name:LAMBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-3525
Mailing Address - Country:US
Mailing Address - Phone:401-679-7331
Mailing Address - Fax:401-435-2561
Practice Address - Street 1:318 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-3525
Practice Address - Country:US
Practice Address - Phone:401-679-7331
Practice Address - Fax:401-435-2561
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-06-29
Deactivation Date:2016-12-30
Deactivation Code:
Reactivation Date:2017-06-08
Provider Licenses
StateLicense IDTaxonomies
RIMD18281207R00000X, 207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program