Healthcare Provider Details

I. General information

NPI: 1992706139
Provider Name (Legal Business Name): RAYMOND F. CHAQUETTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PLAIN ST SUITE 203
PROVIDENCE RI
02905-3240
US

IV. Provider business mailing address

235 PLAIN ST SUITE 203
PROVIDENCE RI
02905-3240
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-9880
  • Fax: 401-272-0840
Mailing address:
  • Phone: 401-272-9880
  • Fax: 401-272-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD06739
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: