Provider Demographics
NPI:1538174909
Name:HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.
Entity type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY ASSOCIATES OF RHODE ISLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNDARESAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMBANDAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-943-4660
Mailing Address - Street 1:1220 PONTIAC AVE
Mailing Address - Street 2:101
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4456
Mailing Address - Country:US
Mailing Address - Phone:401-943-4660
Mailing Address - Fax:401-943-0240
Practice Address - Street 1:1220 PONTIAC AVE
Practice Address - Street 2:101
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4456
Practice Address - Country:US
Practice Address - Phone:401-943-4660
Practice Address - Fax:401-943-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5933245OtherAETNA
RI0000002589OtherBC/BS OF RI
RIDR36986Medicaid
RI0286OtherNEIGHBORHOOD HEALTH PLAN
RICPG0001466OtherRI BLUE CHIP
RI340890OtherTUFTS HP
RICPG0001466OtherRI BLUE CHIP
RI909002589Medicare ID - Type UnspecifiedFEDERAL MEDICARE