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General NPI Number Information
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NPI Number | 1710115480
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Entity Type | Organization
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Legal Business Name | ONCOLOGY HEMATOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 11 WELLS STREET
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City | WESTERLY
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State | RI
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Zip | 02891
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Country | US
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Telephone | 401-596-1630
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Fax | 401-348-9119
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Provider Business Mailing Address
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Address Line | 11 WELLS STREET
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City | WESTERLY
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State | RI
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Zip | 02891
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Country | US
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Telephone | 401-596-1630
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Fax | 401-348-9119
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Authorized Official
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Title or Position | ONCOLOGIST
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Name | MR. ROBERT D LEGARE
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Credential | M.D.
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Telephone | 401-596-1630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD 9559
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License Number State | RI
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