Healthcare Provider Details
I. General information
NPI: 1932202918
Provider Name (Legal Business Name): HISHAM SPIRIDON HOURANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/06/2006
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 HEALTH LN BLDG 2-D
WARWICK RI
02886-2710
US
IV. Provider business mailing address
2649 STRANG BLVD STE 304
YORKTOWN HEIGHTS NY
10598-2939
US
V. Phone/Fax
- Phone: 401-736-4646
- Fax: 401-736-4546
- Phone: 914-739-0087
- Fax: 914-737-1714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | MD18404 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: