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Individual
VIREN ANDREW D'SA
Active
Individual
VIREN ANDREW D'SA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD12388
RI
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD12388
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007059581
MEDICARE PTAN
RI
05
—
VD68530
—
RI
Enumeration date
06/15/2007
Last updated
05/14/2010
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