Basic Information
| Provider Information | |||||||||
| NPI: | 1710935770 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINHANCOS | ||||||||
| FirstName: | FERNANDO | ||||||||
| MiddleName: | BENTO | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53 VINEYARD AVE | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028647215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017249445 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 349 CENTERVILLE RD | ||||||||
| Address2: | OFFICE COMMONS 95, BUILDING 6 | ||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028864324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013846490 | ||||||||
| FaxNumber: | 4013846493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 09/19/2013 | ||||||||
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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 | 174400000X | 01337 | RI | Y | Other Service Providers | Specialist |
No ID Information.