Healthcare Provider Details

I. General information

NPI: 1225082720
Provider Name (Legal Business Name): LATHA PISHARODI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC-12
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC-12
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-7826
  • Fax: 401-444-3578
Mailing address:
  • Phone: 401-444-7826
  • Fax: 401-444-3578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberMD10155
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD10155
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: