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Individual

DR. RICARDO AVELINO DESOUSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 737-4100
Mailing address
1051 CHATHAM LN, ELMIRA, NY 14905-2149
(413) 376-8727

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
251896-1
NY
207L00000X
Anesthesiology Physician
262030
MA

Other

Enumeration date
01/29/2009
Last updated
04/30/2015
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