Provider Demographics
NPI:1649373598
Name:ARONOW, STEFANIE PAIGE (MD)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:PAIGE
Last Name:ARONOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:PAIGE
Other - Last Name:POLSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:900 WARREN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-421-6481
Practice Address - Fax:401-751-8734
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD15210208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
20-1711014OtherTRICARE
MI4905514Medicaid
MI7346282OtherPPOM
MIHAPOtherH34825
MIMIDWEST HP-MEDICAIDOther024916
0H11422OtherBCBS/BCN GROUP
3508143361OtherBS-INDIVIDUAL
MI7346282OtherAETNA
MI7346282OtherPPOM