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1053676627
ANDRE LUIZ PITANGA BASTOS DE SOUZA
PROVIDENCE, RI
NPI
1053676627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207RH0003X Internal Medicine, Hematology & Oncology
(Licence: RI MD16354)
Enumeration Date
2012-07-10
Last Update Date
2018-07-18
Business Address
Dr. ANDRE LUIZ PITANGA BASTOS DE SOUZA M.D
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Phone number: 401-456-5790
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Mailing Address
Dr. ANDRE LUIZ PITANGA BASTOS DE SOUZA M.D
117 ELLENFIELD ST STE 101
PROVIDENCE, RI 02905-4513
Phone number: 401-444-6779
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