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General NPI Number Information
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NPI Number | 1356344089
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Entity Type | Individual
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Provider Name | VINCENT A DECESARIS MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 125 METRO CENTER BLVD STE 2000
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City | WARWICK
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State | RI
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Zip | 02886-1785
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Country | US
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Telephone | 401-432-2500
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Fax | 401-453-8220
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Provider Business Mailing Address
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Address Line | 125 METRO CENTER BLVD STE 2000
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City | WARWICK
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State | RI
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Zip | 02886-1785
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Country | US
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Telephone | 401-432-2500
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Fax | 401-453-8220
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 80777
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | MD04410
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD04410
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License Number State | RI
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