Individual
VINCENT A DECESARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2500
(401) 453-8220
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2500
(401) 453-8220
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
80777
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD04410
RI
2085U0001X
Diagnostic Ultrasound Physician
MD04410
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014362
ME LICENSE
ME
01
—
034414
CT LICENSE
CT
05
—
3123898
—
MA
05
—
7000162
—
RI
01
—
80777
MA LICENSE
MA
01
—
9565
NH LICENSE
NH
01
—
MD04410
RI LICENSE
RI
Enumeration date
05/27/2005
Last updated
08/18/2023
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