Individual
ANTHONY R POTENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
38 HAMLET AVE, WOONSOCKET, RI 02895-4423
(401) 762-0020
(401) 762-1819
Mailing address
38 HAMLET AVE, WOONSOCKET, RI 02895-4423
(401) 762-0020
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD04445
RI
2085U0001X
Diagnostic Ultrasound Physician
MD04445
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3122409
—
MA
01
—
37750
MA LICENSE
MA
05
—
7000164
—
RI
01
—
MD04445
RI LICENSE
RI
Enumeration date
05/27/2005
Last updated
09/28/2011
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