Individual
NINA TATEVIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
101 DUDLEY ST, PATHOLOGY DEPARTMENT, PROVIDENCE, RI 02905-2401
(401) 453-7655
Mailing address
455 TOLL GATE RD, PRC AND CREDENTIALING, WARWICK, RI 02886-2759
(401) 273-0641
(401) 273-2919
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD10517
RI
207ZP0213X
Pediatric Pathology Physician
MD10517
RI
Other
Enumeration date
05/25/2006
Last updated
08/05/2025
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