Provider Demographics
NPI:1215024963
Name:SANI, OMEED (MD)
Entity Type:Individual
Prefix:
First Name:OMEED
Middle Name:
Last Name:SANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEMORIAL HOSPITAL OF RHODE ISAND
Mailing Address - Street 2:111 BREWSTER STREET
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4499
Mailing Address - Country:US
Mailing Address - Phone:401-729-2142
Mailing Address - Fax:401-729-2544
Practice Address - Street 1:MEMORIAL HOSPITAL OF RHODE ISAND
Practice Address - Street 2:111 BREWSTER STREET
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4499
Practice Address - Country:US
Practice Address - Phone:401-729-2142
Practice Address - Fax:401-729-2544
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine