Healthcare Provider Details

I. General information

NPI: 1538195144
Provider Name (Legal Business Name): JOHN JOSEPH PRZYGODA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 TOLL GATE RD
WARWICK RI
02886-4458
US

IV. Provider business mailing address

215 TOLL GATE RD
WARWICK RI
02886-4458
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-5900
  • Fax: 401-732-9726
Mailing address:
  • Phone: 401-732-5900
  • Fax: 401-732-9726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number5455
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: