Provider Demographics
NPI:1932194198
Name:SANTORO, PAUL W (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:SANTORO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 VETERANS MEMORIAL PKWY UNIT 15B
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-5300
Mailing Address - Country:US
Mailing Address - Phone:401-434-3350
Mailing Address - Fax:401-434-5230
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY UNIT 15B
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-434-3350
Practice Address - Fax:401-434-5230
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA239233207R00000X
RIDO00525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050483739OtherTIN #