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General NPI Number Information
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NPI Number | 1396109146
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Entity Type | Individual
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Provider Name | TABASSUM FIROZ MD, MSC, FRCPC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 146 WEST RIVER STREET SUITE 11D
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City | PROVIDENCE
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State | RI
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Zip | 02905
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Country | US
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Telephone | 401-793-5700
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Fax | 401-793-7801
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Provider Business Mailing Address
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Address Line | 146 WEST RIVER STREET SUITE 11C
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City | PROVIDENCE
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State | RI
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Zip | 02905
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Country | US
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Telephone | 401-793-5700
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Fax | 401-793-7801
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD15296
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License Number State | RI
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