Individual
STEFAN SANTO BALESTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
25 GARWAINE DR, LINCOLN, RI 02865-4905
(401) 864-6700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01453
RI
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
02/13/2026
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