Thavaseelan, Simone

Thavaseelan, Simone is an individual health care provider with primary practice located at 2 Dudley St Ste 185 , Providence RI 02905-3247. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Thavaseelan, Simone can be contacted via phone (401) 444-5795.

Contact Information

Primary practice address
2 Dudley St Ste 185 Providence RI 02905-3247
Phone: (401) 444-5795
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD13391 Rhode Island

Profile Details

NPI number 1053530782
LBN Legal business name Thavaseelan, Simone
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2007
Last updated Oct 14th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053530782 NPPES
Rhode Island Other 349005986 MEDICARE GROUP PTAN
Rhode Island Other 1659463230 MEDICARE GROUP PTAN

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