Individual
NOUBAR KESSIMIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 BREWSTER ST, DEPARTMENT OF PATHOLOGY, PAWTUCKET, RI 02860-4400
(401) 729-2392
(401) 729-2990
Mailing address
111 BREWSTER ST, WOOD BLDG #516, PAWTUCKET, RI 02860-4400
(401) 729-3481
(401) 729-2721
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD05825
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007061041
MEDICARE PTAN
RI
05
—
7002239
—
RI
Enumeration date
12/07/2005
Last updated
05/26/2010
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