Provider Demographics
NPI:1316980121
Name:BARONE, ANTHONY J (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:BARONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RESERVOIR AVENUE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910
Mailing Address - Country:US
Mailing Address - Phone:401-944-6510
Mailing Address - Fax:401-943-2379
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4448
Practice Address - Country:US
Practice Address - Phone:401-944-6510
Practice Address - Fax:401-943-2379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI5879207YX0007X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI294676OtherBLUE CROSS BLUE SHEILD
RI711930OtherTUFTS
RI200847OtherBLUE CHIP
RI9000443Medicaid
RI200847OtherBLUE CHIP
RIC89901Medicare UPIN