Dr. Andre Luiz Pitanga Bastos De Souza
Hematology & Oncology
825 Chalkstone Ave
Providence
, Rhode Island 02908
Dr. Andre Luiz Pitanga Bastos De Souza
Hematology & Oncology
825 Chalkstone Ave
Providence
, Rhode Island 02908
(401) 444-6912
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About
Features
Specialties
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Dr. Andre Luiz Pitanga Bastos De Souza
- 117 Ellenfield St Ste 101
- Providence, RI
- Zip : 02905-4513
- Fax : (401) 444-6912
- Phone : (401) 444-6779
Second Address
- Dr. Andre Luiz Pitanga Bastos De Souza
- 825 Chalkstone Ave
- Providence, RI
- Zip : 02908
- Phone : (401) 456-5790
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RH0003X | Hematology & Oncology | MD16354 | RI |
National Provider Identifier
| NPI | 1053676627 |
|---|---|
| Provider Name | Dr. Andre Luiz Pitanga Bastos De Souza |
| First Address | Providence, RI 02905-4513 |
| Second Address | Providence, RI 02908 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/07/2012 |
| Last Update Date | 18/07/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.