Healthcare Provider Details

I. General information

NPI: 1538174909
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 PONTIAC AVE 101
CRANSTON RI
02920-4456
US

IV. Provider business mailing address

1220 PONTIAC AVE 101
CRANSTON RI
02920-4456
US

V. Phone/Fax

Practice location:
  • Phone: 401-943-4660
  • Fax: 401-943-0240
Mailing address:
  • Phone: 401-943-4660
  • Fax: 401-943-0240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUNDARESAN SAMBANDAM
Title or Position: PRESIDENT
Credential: MD
Phone: 401-943-4660