Healthcare Provider Details

I. General information

NPI: 1912074675
Provider Name (Legal Business Name): CHILDREN'S CHOICE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 WASHINGTON ST
WEST WARWICK RI
02893-4927
US

IV. Provider business mailing address

37 WASHINGTON ST
WEST WARWICK RI
02893-4927
US

V. Phone/Fax

Practice location:
  • Phone: 401-381-0066
  • Fax: 401-381-0068
Mailing address:
  • Phone: 401-381-0066
  • Fax: 401-381-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARIM ZOOL KHANBHAI
Title or Position: M.D
Credential: M.D
Phone: 401-381-0066