Individual
RAJVI GAUTAM BROKER-SEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 331-1350
(401) 277-3366
Mailing address
PO BOX 6688, PROVIDENCE, RI 02940-6688
(401) 331-1350
(401) 277-3366
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
257852
MA
Other
Enumeration date
08/09/2007
Last updated
03/21/2019
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