Organization
PROVIDENCE UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY M IANNOTTI MD (PRESIDENT)
(401) 521-4333
Entity
Organization
Contact information
Practice address
1165 N MAIN ST, SUITE 200, PROVIDENCE, RI 02904-5740
(401) 521-4333
(401) 521-4377
Mailing address
340 MAIN ST, STE. 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 438-6368
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9003351
—
RI
Enumeration date
05/23/2006
Last updated
12/06/2011
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