Individual
DR. PAMELA JO SAN ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
161 AIRPORT ROAD, WARWICK, RI 02889
(401) 737-4282
(401) 738-6896
Mailing address
161 AIRPORT ROAD, WARWICK, RI 02889
(401) 737-4282
(401) 738-6896
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6409
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200217
UNITED HEALTH PLAN
—
01
—
200408
BCBS
RI
01
—
201242
CHCP BLUE CHIP
RI
01
—
406495
TUFTS HEALTH PLAN
—
01
—
4720780
CIGNA INSURANCE
—
01
—
6409
STATE LICENSE
RI
01
—
6591
NEIGHBORHOOD HEALTH PLAN
RI
05
—
9920040
—
RI
01
—
A3417A
HARVARD PILGRIM INS
—
Enumeration date
12/21/2005
Last updated
04/16/2014
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