Individual
KENNETH CUSHING BOTELHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 VETERANS MEMORIAL PKWY BLDG 9, EAST PROVIDENCE, RI 02914-5300
(401) 435-5533
(401) 435-3586
Mailing address
450 VETERANS MEMORIAL PKWY BLDG 9, EAST PROVIDENCE, RI 02914-5300
(401) 435-5533
(401) 435-3586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15285
MN
363A00000X
Physician Assistant
Primary
PA00716
RI
Other
Enumeration date
10/23/2012
Last updated
05/16/2025
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