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General NPI Number Information
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NPI Number | 1801771985
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Entity Type | Individual
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Provider Name | ALEXANDER PEDUS
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Gender | Male
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 823 MAIN ST
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City | HOPE VALLEY
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State | RI
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Zip | 02832-1920
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Country | US
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Telephone | 401-387-9630
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Fax |
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Provider Business Mailing Address
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Address Line | 33 BRAMBLE LN
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City | WEST WARWICK
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State | RI
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Zip | 02893-5505
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Country | US
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Telephone | 401-595-0467
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT04027
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License Number State | RI
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