ETHAN PRINCE (NPI# 1306064563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306064563 |
| Entity Type | Individual |
| Full Name | ETHAN PRINCE |
| Practice Address |
125 Metro Center Blvd Ste 2000 Warwick RI 02886-1785 |
| Practice Telephone | 4014322520 |
| Practice Fax Number | 4019219212 |
| Mailing Telephone | 4014322520 |
| Mailing Fax Number | 4019219212 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD12864 | RI | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
LP00309 | RI | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
12864 | RI | Allopathic & Osteopathic Physicians |
| Street Address |
125 METRO CENTER BLVD STE 2000 |
| City | WARWICK |
| State | RI |
| Zip Code | 02886-1785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344089 | Vincent A Decesaris | Radiology | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2005-05-27 |
| 1104386895 | Vincent Alexandre | Physician Assistant | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2019-03-20 |
| 1639625288 | Whitney Kristina Vayntrub | Physician Assistant | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886 | 2016-09-01 |
| 1306390869 | Eric Boettjer | Physician Assistant | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2016-08-12 |
| 1275949414 | Monica L Roca | Radiology | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2014-07-09 |
| 1962746552 | Jose Graterol | Radiology Practitioner Assistant | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2012-11-20 |
| 1699034710 | Z Liu | Internal Medicine | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1768 | 2012-05-09 |
| 1235404146 | Janelle Bosse | Physician Assistant | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2012-03-12 |
| 1174818603 | Elizabeth H Dibble | Radiology | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2011-06-13 |
| 1093021966 | Gaurav Jindal | Radiology | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2010-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694445 | Sheri Lynn Sklarz | Specialist | 300 Quaker Lane, Miracle Ear Suite C15, Warwick, RI 02886 | 2020-03-23 |
| 1316581424 | Dr. Degiulio & Associates Inc | Optometrist | 400 Bald Hill Road Ste 163, Warwick Mall, Warwick, RI 02886 | 2019-10-31 |
| 1255813291 | Samantha Pena Moore | Behavioral Analyst | 3446 Post Road, Warwick, RI 02886 | 2018-09-06 |
| 1912496209 | Martin Jude Cotti | Internal Medicine | 455 Toll Gate Rd., Warwick, RI 02886 | 2018-05-02 |
| 1447764261 | Cynthia A Lessard | Nurse Practitioner | 15 Health Lane, Warwick, RI 02886 | 2017-12-01 |
| 1538687520 | David A. Bennett | Registered Nurse | 2756 Post Road, Warwick, RI 02886 | 2017-08-30 |
| 1427585223 | Brittany Teixeira | Counselor | 85 Earl Street, Warwick, RI 02886 | 2017-05-11 |
| 1497125199 | Aiden Philip Cwynar | Optometrist | 1050 Centerville Road, Warwick, RI 02886 | 2015-10-07 |
| 1104221738 | Wilfredo L Sancianco Dmd Inc | Preferred Provider Organization | 3411 W Shiore Rd, Warwick, RI 02886 | 2014-10-24 |
| 1831508662 | Matthew Bryant Mitchell | Physical Therapist | 400 Bald Hill Rd #511, Warwick, RI 02886 | 2014-08-06 |
| Find all providers in zip 02886 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407928179 | Endovascular & Interventional Associates Inc | Radiology | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2006-11-15 |
| 1205874930 | Rhode Island Medical Imaging | Radiology | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886-1785 | 2006-06-03 |
| 1427055987 | Landy Peter Paolella | Radiology | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2005-06-30 |
| 1356348817 | Robert Edward Binek | Radiology | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900286 | Silver Spring Health Care Management, Inc | Radiology | 100 Kenyon Ave, Wakefield, RI 02879-4216 | 2020-07-31 |
| 1134742588 | Sean O'neill | Radiology | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-20 |
| 1497318620 | Jessica Yoon | Radiology | 593 Eddy St, Providence, RI 02903-4923 | 2019-04-14 |
| 1346733102 | Adam Charles Tuomi | Radiology | 593 Eddy St, Providence, RI 02903-4923 | 2018-06-07 |
| 1568880029 | Rylee Olewinski | Radiology | 593 Eddy St, Providence, RI 02903-4923 | 2014-04-02 |
| 1922121185 | Providence Interventional Associates, LLC | Radiology | 100 Highland Ave, Providence, RI 02906-2740 | 2007-04-10 |
| 1285617845 | Brian F Stainken | Radiology | 825 Chalkstone Ave, Roger Williams Medical Center - Imaging Network of Ri, Providence, RI 02908-4728 | 2005-11-28 |
| 1295725042 | Michael E Jay | Radiology | 111 Brewster Street, Pawtucket, RI 02860-4474 | 2005-10-24 |
Please comment or provide details below to improve the information on ETHAN PRINCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.