Healthcare Provider Details

I. General information

NPI: 1811059538
Provider Name (Legal Business Name): JAMES ANDRIOTIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989 RESERVOIR AVE STE 101
CRANSTON RI
02910-5138
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 401-572-3313
  • Fax:
Mailing address:
  • Phone: 401-572-3313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD12300
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD12300
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: