Healthcare Provider Details

I. General information

NPI: 1417063603
Provider Name (Legal Business Name): RAFFI CALIKYAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 ATWOOD AVE STE 220
JOHNSTON RI
02919-3278
US

IV. Provider business mailing address

1524 ATWOOD AVE STE 220
JOHNSTON RI
02919-3278
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-1900
  • Fax: 401-453-3049
Mailing address:
  • Phone: 401-272-1900
  • Fax: 401-453-3049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number9894
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: