Faridah Tanya B Rodriguez (NPI# 1902050503, PAC ID# 9931225448) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1902050503 |
| PAC ID by PECOS | 9931225448 |
| Professional Enrollment ID | I20100921001511 |
| Full Name | Faridah Tanya B Rodriguez |
| Organization Legal Name | LIFESPAN PHYSICIAN GROUP INC |
| Address |
77 Turnpike Ave Portsmouth RI 02871-1419 |
| Phone Number | 4018637070 |
| Gender | F |
| Graduation Year | 2003 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2567455082 |
| Number of Group Practice Members | 600 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410012 | THE MIRIAM HOSPITAL |
| 410006 | NEWPORT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 77 Turnpike Ave, Portsmouth, RI 02871-1419 | 4018637070 | LIFESPAN PHYSICIAN GROUP INC |
| 711 Main Rd, Tiverton, RI 02878-1352 | 4016241400 | LIFESPAN PHYSICIAN GROUP INC |
| Organization Legal Name | LIFESPAN PHYSICIAN GROUP INC |
| Physicians | 560 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roy Souaid | Internal Medicine | Lifespan Physician Group Inc | 1500 Pontiac Ave, Suite 101, Cranston, RI 02920-4486 |
| Amritpal Singh Jawanda | Family Medicine | Lifespan Physician Group Inc | 639 Metacom Ave, Warren, RI 02885-2348 |
| Alisha Lakhani | Rheumatology | Lifespan Physician Group Inc | 407 E Ave, Suite 250, Pawtucket, RI 02860-5290 |
| Leah R Battista | Obstetrics/gynecology | Lifespan Physician Group Inc | 148 W River St, Suite 1g, Providence, RI 02904-2615 |
| Mahmoud Mowafy | Internal Medicine | Lifespan Physician Group Inc | 164 Summit Ave, Providence, RI 02906-2853 |
| Caroline Sizer | Physical Medicine and Rehabilitation | Lifespan Physician Group Inc | 765 Allens Ave, Suite 110, Providence, RI 02905-5443 |
| Christine Michele Leddy | Psychiatry | Lifespan Physician Group Inc | 11 Friendship St, Newport, RI 02840-2209 |
| Dana Siperstein | Psychiatry | Lifespan Physician Group Inc | 167 Point St, Providence, RI 02903-4771 |
| Brady Geronimo Case | Psychiatry | Lifespan Physician Group Inc | 1011 Veterans Memorial Pkwy, Riverside, RI 02915-5061 |
| Maurice Francis Joyce Iii | Anesthesiology | Lifespan Physician Group Inc | 55 Lambert Lind Hwy, Warwick, RI 02886-1074 |
| Street Address |
77 TURNPIKE AVE |
| City | PORTSMOUTH |
| State | RI |
| Zip | 02871-1419 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert L Desrosiers | Nurse Practitioner | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Larry A Evans | Dermatology | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Kristin Fielding | Family Medicine | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Anne E Neuville | Nurse Practitioner | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Ma Liza Ann Famador | Family Medicine | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Triste M Coulombe | Obstetrics/gynecology | Lifespan Physician Group Inc | 77 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ravi V Nadimpalli | Gastroenterology | University Gastroenterology, LLC | 110 Clock Tower Sq, Fl 2, Portsmouth, RI 02871-1396 |
| Margaret Camacho | Psychologist, Clinical | 107 Clock Tower Sq, Portsmouth, RI 02871-1396 | |
| Erica Von Villas | Clinical Social Worker | 101 Clock Tower Sq, Portsmouth, RI 02871-1396 | |
| Michael Joseph Moylan Jr. | Nurse Practitioner | University Gastroenterology, LLC | 110 Clock Tower Sq, Fl 2, Portsmouth, RI 02871-1396 |
| Sara R Duggan | Clinical Social Worker | 107 Clock Tower Sq, Portsmouth, RI 02871-1396 | |
| Susan M Killebrew | Clinical Social Worker | 107 Clock Tower Sq, Portsmouth, RI 02871-1396 | |
| Carla M Evans | Nurse Practitioner | Lifespan Physician Group Inc | 79 Turnpike Ave, Portsmouth, RI 02871-1419 |
| Jillian Fenton | Clinical Social Worker | 11 King Charles Dr, Suite A4, Portsmouth, RI 02871-1446 | |
| John E Zeller | Psychologist, Clinical | 11 King Charles Dr, Suite A3b, Portsmouth, RI 02871-1446 | |
| Ronald P Marsh | Chiropractic | 11 King Charles Dr, Portsmouth, RI 02871-1446 | |
| Find all physicians in zip 02871 | |||
| City | PORTSMOUTH |
| Zip Code | 02871 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PORTSMOUTH + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Faridah Tanya B Rodriguez.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.