Basic Information
| Provider Information | |||||||||
| NPI: | 1710098249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTORO | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1681 CRANSTON ST | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029205000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019446889 | ||||||||
| FaxNumber: | 4019446726 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 RESERVOIR AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018294446 | ||||||||
| FaxNumber: | 4018294434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11412 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1396864542 | 01 | RI | NPI KENT HOSPITAL PBO | OTHER | 7056491 | 05 | RI | MEDICAID |