Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 247764 | MA |
Y | 207L00000X | Anesthesiologist | DO00785 | RI |
NPI | 1003012014 |
---|---|
Provider Name | Dr. Keith-Austin Scarfo |
First Address | Providence, RI 02905-4513 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 09/06/2015 |