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General NPI Number Information
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NPI Number | 1346228988
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Entity Type | Individual
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Provider Name | RICHARD P SAN ANTONIO MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 215 TOLL GATE RD SUITE 305
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City | WARWICK
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State | RI
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Zip | 02886-4458
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Country | US
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Telephone | 401-738-2601
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Fax | 401-738-2660
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Provider Business Mailing Address
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Address Line | 215 TOLL GATE RD SUITE 305
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City | WARWICK
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State | RI
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Zip | 02886-4458
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Country | US
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Telephone | 401-738-2601
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Fax | 401-738-2660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 6410
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License Number State | RI
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