Healthcare Provider Details

I. General information

NPI: 1174256788
Provider Name (Legal Business Name): PRIYA HOTWANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRIYA HOTWANI MD

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-3985
  • Fax: 401-444-3986
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD21349
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11022611A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: