=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730392390
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANDRZEJ J STANKIEWICZ MD PHD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 HIGH SERVCE AVENUE MARIAN HALL 2ND FLOOR
-----------------------------------------------------
City | NORTH PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02904-5113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-456-3064
-----------------------------------------------------
Fax | 401-752-8247
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 HIGH SERVCE AVENUE MARIAN HALL 2ND FLOOR
-----------------------------------------------------
City | NORTH PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02904-5113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-456-3064
-----------------------------------------------------
Fax | 401-752-8247
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANDRZEJ J STANKIEWICZ
-----------------------------------------------------
Credential | MD PHD
-----------------------------------------------------
Telephone | 401-456-3064
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | RI7157
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | MA57821
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------