Healthcare Provider Details

I. General information

NPI: 1730839309
Provider Name (Legal Business Name): ROMAN DROZDOWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 S COUNTY TRL
EAST GREENWICH RI
02818-5098
US

IV. Provider business mailing address

526 MAIN ST STE 302
ACTON MA
01720-3310
US

V. Phone/Fax

Practice location:
  • Phone: 401-885-7546
  • Fax: 401-885-6640
Mailing address:
  • Phone: 978-371-7010
  • Fax: 978-371-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD21332
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1027653
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: