MEDICARE: MR. WILLIAM G. SAN ANTONIO III MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	ISW00219	RI

General Provider Information

NPI Number	:	1720075815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM G. SAN ANTONIO III MSW

Provider Business Mailing Address
First Line	:	36 VALE AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4318
Country	:	US
Telephone Number	:	401-275-0290
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 LAFAYETTE ST
Second Line	:	SUITE 305
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-6008
Country	:	US
Telephone Number	:	401-942-5553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	01/23/2026

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