1538174909 NPI number — HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.

Table of content: (NPI 1538174909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538174909 NPI number — HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538174909
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 PONTIAC AVE
Provider Second Line Business Mailing Address:
101
Provider Business Mailing Address City Name:
CRANSTON
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02920-4456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-943-4660
Provider Business Mailing Address Fax Number:
401-943-0240

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1220 PONTIAC AVE
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
CRANSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02920-4456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-943-4660
Provider Business Practice Location Address Fax Number:
401-943-0240
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SAMBANDAM
Authorized Official First Name:
SUNDARESAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
401-943-4660

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5933245 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000002589 . This is a "BC/BS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: DR36986 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0286 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: CPG0001466 . This is a "RI BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 340890 . This is a "TUFTS HP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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