Healthcare Provider Details

I. General information

NPI: 1174972582
Provider Name (Legal Business Name): ELIZABETH CATHERINE FERRANTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH CATHERINE VANDEVENTER

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

125 METRO CENTER BLVD STE 2000
WARWICK RI
02886-1785
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-2133
  • Fax:
Mailing address:
  • Phone: 401-432-2500
  • Fax: 401-889-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number267116
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number291945
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD18338
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: