Healthcare Provider Details

I. General information

NPI: 1861445728
Provider Name (Legal Business Name): NARRAGANSETT BAY ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

IV. Provider business mailing address

42 ORIENTAL ST
PROVIDENCE RI
02908-3238
US

V. Phone/Fax

Practice location:
  • Phone: 781-915-0214
  • Fax: 781-407-7712
Mailing address:
  • Phone: 774-319-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ROSANNE ANDRADE
Title or Position: SR. NATIONAL ENROLLMENT MANAGER
Credential:
Phone: 972-663-8523