Individual provider · NPI-1

Siraj Amanullah, MD

Pediatrics, Pediatric Emergency Medicine · Providence, RI

NPI number1952322802
StatusActive
Last updated in NPPESNov 29, 2023

Details

NPI
1952322802
Entity type
Individual (NPI-1)
Name
Siraj Amanullah
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 23, 2006
Certification date
Dec 21, 2022
Last updated
Nov 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0204X Pediatrics, Pediatric Emergency MedicineMD10763RIYes
208000000X PediatricsMD10763RI

Practice location

593 Eddy St
Claverick 2
Providence, RI 02903-4923

Phone 401-854-2504 · Fax 401-854-2519

Mailing address

125 Whipple St Ste 3
Providence, RI 02908-3258

Phone 401-519-0330

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