Individual
PASQUALE ANTHONY MASTROSTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
347 BROADWAY, PROVIDENCE, RI 02909
(401) 351-1560
(401) 351-1560
Mailing address
347 BROADWAY, PROVIDENCE, RI 02909
(401) 351-1560
(401) 351-1560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3995
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001433
BLUE CHIP
RI
01
—
6066 RIBC
BLUE CROSS BLUE SHEILD
RI
05
—
9000606
—
RI
Enumeration date
11/14/2006
Last updated
07/08/2007
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