Viren Andrew D'sa, MD | |
555 Prospect St, Pawtucket, RI 02860-6200 | |
(401) 729-6200 | |
(401) 729-6203 |
Full Name | Viren Andrew D'sa |
---|---|
Gender | Male |
Speciality | Pediatrics - Developmental - Behavioral Pediatrics |
Location | 555 Prospect St, Pawtucket, Rhode Island |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326243866 | NPI | - | NPPES |
007059581 | Other | RI | MEDICARE PTAN |
VD68530 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD12388 (Rhode Island) | Secondary |
2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | MD12388 (Rhode Island) | Primary |
Entity Name | Rhode Island Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861420333 PECOS PAC ID: 8921900044 Enrollment ID: O20040121000169 |
Mailing Address | Practice Location Address |
---|---|
Viren Andrew D'sa, MD 111 Brewster St, Wood 516, Pawtucket, RI 02860-4400 Ph: (401) 729-2250 | Viren Andrew D'sa, MD 555 Prospect St, Pawtucket, RI 02860-6200 Ph: (401) 729-6200 |
Natalia Lukankina, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-6200 | |
Tanya Jean Becker, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 126 Prospect St, Pawtucket, RI 02860 Phone: 401-728-9206 Fax: 401-722-6960 | |
Esther J. Entin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 111 Brewster St, Department Of Pediatrics, Pawtucket, RI 02860 Phone: 401-729-6200 Fax: 401-729-6203 | |
Kunjbala Sharma, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1145 Main St, Pawtucket, RI 02860 Phone: 401-722-0081 Fax: 401-312-0318 | |
Carol L Baum-gupta, Pediatrics Medicare: Medicare Enrolled Practice Location: 555 Prospect Street, Pawtucket, RI 02860 Phone: 401-729-6200 Fax: 401-729-6203 | |
Cameron Elizabeth Walker Lang, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 39 East Ave, Pawtucket, RI 02860 Phone: 401-722-0081 Fax: 401-312-0318 |