Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 150253 | MA |
N | 207V00000X | Obstetrician & Gynecologist | 41866 | CT |
N | 207V00000X | Obstetrician & Gynecologist | MD08105 | RI |
N | 207VX0000X | Obstetrician | 41866 | CT |
N | 207VX0201X | Gynecologic Oncologist | 150253 | MA |
N | 207VX0201X | Gynecologic Oncologist | 41866 | CT |
Y | 207VX0201X | Gynecologic Oncologist | MD08105 | RI |
NPI | 1174559603 |
---|---|
Provider Name | Mr. Paul Andrew Disilvestro |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 28/12/2021 |