Healthcare Provider Details

I. General information

NPI: 1831418599
Provider Name (Legal Business Name): ARIANA PAULA BENSUSAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HEALTH LN # 2D
WARWICK RI
02886
US

IV. Provider business mailing address

15 HEALTH LN # 2D
WARWICK RI
02886-2710
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-7000
  • Fax:
Mailing address:
  • Phone: 401-737-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102202630
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number305058
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberDO00926
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: