Healthcare Provider Details

I. General information

NPI: 1346467560
Provider Name (Legal Business Name): ERICA SZABADOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 RESERVOIR AVE SUITE 308
CRANSTON RI
02910-4448
US

IV. Provider business mailing address

725 RESERVOIR AVE SUITE 308
CRANSTON RI
02910-4448
US

V. Phone/Fax

Practice location:
  • Phone: 401-944-9559
  • Fax: 401-944-7501
Mailing address:
  • Phone: 401-944-9559
  • Fax: 401-944-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberLP00263
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberMD12669
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: