ANDRE LUIZ PITANGA BASTOS DE SOUZA

PROVIDENCE, RI
NPI1053676627
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: RI  MD16354)
Enumeration Date2012-07-10
Last Update Date2018-07-18
Business Address
Dr. ANDRE LUIZ PITANGA BASTOS DE SOUZA M.D
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Phone number: 401-456-5790
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