Provider Demographics
NPI:1699166009
Name:OU, PRANY
Entity type:Individual
Prefix:
First Name:PRANY
Middle Name:
Last Name:OU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 PUTNAM PIKE
Mailing Address - Street 2:SUITE A-250
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2440
Mailing Address - Country:US
Mailing Address - Phone:401-232-2854
Mailing Address - Fax:401-757-3266
Practice Address - Street 1:371 PUTNAM PIKE
Practice Address - Street 2:SUITE A-250
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2440
Practice Address - Country:US
Practice Address - Phone:401-232-2854
Practice Address - Fax:401-757-3266
Is Sole Proprietor?:No
Enumeration Date:2015-02-08
Last Update Date:2015-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPH102744247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other