Provider Demographics
NPI:1699720961
Name:VAZ, ROSALIND (MD)
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:
Last Name:VAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:HASBRO 122
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-6484
Mailing Address - Fax:401-444-6378
Practice Address - Street 1:1 HOPPIN ST
Practice Address - Street 2:CORO WEST
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4141
Practice Address - Country:US
Practice Address - Phone:401-444-5980
Practice Address - Fax:401-444-3873
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI071762080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002232Medicaid
RI7002232Medicaid