Healthcare Provider Details

I. General information

NPI: 1437463056
Provider Name (Legal Business Name): ALEJANDRO VAZQUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 POST RD
WARWICK RI
02886-7140
US

IV. Provider business mailing address

3520 POST RD
WARWICK RI
02886-7140
US

V. Phone/Fax

Practice location:
  • Phone: 401-921-5800
  • Fax: 401-921-5826
Mailing address:
  • Phone: 401-921-5800
  • Fax: 401-921-5826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD15427
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: