Provider Demographics
NPI:1710935770
Name:PINHANCOS, FERNANDO BENTO (MSPT)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:BENTO
Last Name:PINHANCOS
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HAWKINS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4450
Mailing Address - Country:US
Mailing Address - Phone:401-345-2428
Mailing Address - Fax:
Practice Address - Street 1:250 CENTERVILLE RD BLDG A
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4353
Practice Address - Country:US
Practice Address - Phone:401-384-6490
Practice Address - Fax:401-384-6493
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI01337174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007057981Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE