=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679483168
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRAULIO SANCHEZ
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2026
-----------------------------------------------------
Last Update Date | 09/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24 HYMER ST STE B
-----------------------------------------------------
City | NORTH PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02908-1316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-663-0325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 280 WASHINGTON ST APT 711
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02903-3606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-457-8375
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number | 202105
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------