Provider Demographics
NPI:1245267681
Name:ANGELA L. KARAVASILIS, DO, INC.
Entity type:Organization
Organization Name:ANGELA L. KARAVASILIS, DO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:LITSA
Authorized Official - Last Name:KARAVASILIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-475-7650
Mailing Address - Street 1:2 WAKE ROBIN RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4241
Mailing Address - Country:US
Mailing Address - Phone:401-475-7650
Mailing Address - Fax:407-475-7655
Practice Address - Street 1:2 WAKE ROBIN RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4241
Practice Address - Country:US
Practice Address - Phone:401-475-7650
Practice Address - Fax:407-475-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty