Provider Demographics
NPI:1467576843
Name:RAUFI, NOOREDIN (MD)
Entity Type:Individual
Prefix:
First Name:NOOREDIN
Middle Name:
Last Name:RAUFI
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 1:245 CHAPMAN STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4507
Mailing Address - Country:US
Mailing Address - Phone:401-490-0916
Mailing Address - Fax:401-490-0917
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:DAVOL 129
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4933
Practice Address - Fax:401-444-5083
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI4359207L00000X
RIMD04359207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7001949Medicaid
RI7001949Medicaid
RI007001949Medicare ID - Type UnspecifiedMEDICARE PROV NUMBER