Healthcare Provider Details

I. General information

NPI: 1821910407
Provider Name (Legal Business Name): THOMAS MIKHAIL ZUBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ATWOOD AVE
CRANSTON RI
02920-4047
US

IV. Provider business mailing address

205 ATWOOD AVE
CRANSTON RI
02920-4047
US

V. Phone/Fax

Practice location:
  • Phone: 401-942-4100
  • Fax: 401-942-3663
Mailing address:
  • Phone: 401-942-4100
  • Fax: 401-942-3663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH06893
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: