Healthcare Provider Details

I. General information

NPI: 1649237538
Provider Name (Legal Business Name): ANDREW S. TREIBWASSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 08/20/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAMBERT LIND HIGHWAY
WARWICK RI
02886
US

IV. Provider business mailing address

75 NEWMAN AVE SUITE 100
RUMFORD RI
02916
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-4711
  • Fax: 401-732-0419
Mailing address:
  • Phone: 401-453-0666
  • Fax: 401-415-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number7503
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD07503
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: