Kenneth E Fonguck
Nurse Practitioner, Psych/Mental Health in Woonsocket, Rhode Island
1265028781- Practice location
- 1 CVS Dr, Woonsocket, RI 02895-6146
- Phone
- 402-419-6291
- Fax
- —
- Last updated
- March 19, 2026
Kenneth Elad Fonguck is a Nurse Practitioner, Psych/Mental Health based in Woonsocket, RI. Kenneth Elad Fonguck practices in Woonsocket, RI. The NPI Number for Kenneth Elad Fonguck is 1265028781 and holds a License No. APRN-NP296175 (GA). The current practice location address for Kenneth Elad Fonguck is 1 CVS Dr, Woonsocket, RI 02895-6146 and can be reached out via phone at 402-419-6291.
Provider Profile Details
- NPI Number
- 1265028781
- Provider Name
- Kenneth Elad Fonguck
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1 CVS Dr, Woonsocket, RI 02895-6146
- Phone Number
- 402-419-6291
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- December 18, 2020
- Last Update Date
- March 19, 2026
- Certification Date
- March 19, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 CVS Dr
Woonsocket, RI 02895-6146 - City
- Woonsocket
- State
- Rhode Island
- Zip
- 02895-6146
- Phone Number
- 402-419-6291
Provider Business Mailing Address Details
- Address
- 3768 Southfield CT
Loganville, GA 30052-4863 - City
- Loganville
- State
- GA
- Zip
- 30052-4863
- Phone Number
- 404-643-9031
License Information
- License Number
- APRN-NP296175
- License State
- GA
- Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kenneth E Fonguck?
The NPI number of Kenneth E Fonguck is 1265028781. It was assigned on December 18, 2020 and is currently active in the NPPES registry.
What is the specialty of Kenneth E Fonguck?
Kenneth E Fonguck is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in GA under license number APRN-NP296175.
Where does Kenneth E Fonguck practice?
The practice location is 1 CVS Dr, Woonsocket, RI 02895-6146. The office can be reached at 402-419-6291 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1265028781 directly on the NPPES registry website.