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General NPI Number Information
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NPI Number | 1104372101
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Entity Type | Organization
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Legal Business Name | JAMES AZAR
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 123 EVANS AVE
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City | TIVERTON
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State | RI
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Zip | 02878-4327
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Country | US
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Telephone | 401-682-2282
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Fax |
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Provider Business Mailing Address
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Address Line | 2679 E MAIN RD
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City | PORTSMOUTH
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State | RI
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Zip | 02871-2613
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Country | US
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Telephone | 401-682-2282
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JAMES AZAR
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Credential |
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Telephone | 401-682-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS409
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License Number State | RI
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