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General NPI Number Information
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NPI Number | 1245267681
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Entity Type | Organization
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Legal Business Name | ANGELA L. KARAVASILIS, DO, INC.
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 WAKE ROBIN RD SUITE 208
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone | 401-475-7650
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Fax | 407-475-7655
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Provider Business Mailing Address
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Address Line | 2 WAKE ROBIN RD SUITE 208
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone | 401-475-7650
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Fax | 407-475-7655
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | ANGELA LITSA KARAVASILIS
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Credential | DO
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Telephone | 401-475-7650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO00505
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License Number State | RI
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