Basic Information
| Provider Information | |||||||||
| NPI: | 1225230444 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HYDER | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DENUCCI | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | MARIE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 375 WAMPANOAG TRL | ||||||||
| Address2: | 2ND FLOOR, SUITE 202A | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029152232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4016494030 | ||||||||
| FaxNumber: | 4016494031 | ||||||||
| Practice Location | |||||||||
| Address1: | 375 WAMPANOAG TRL | ||||||||
| Address2: | 2ND FLOOR, SUITE 202A | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029152232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4016494030 | ||||||||
| FaxNumber: | 4016494031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 02/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LP01040 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD13414 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 16589 | NH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | MD13414 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.