Provider Demographics
NPI:1821037672
Name:URBANIAK, HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:URBANIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 PAWTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6057
Mailing Address - Country:US
Mailing Address - Phone:401-722-2400
Mailing Address - Fax:401-728-3920
Practice Address - Street 1:588 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6057
Practice Address - Country:US
Practice Address - Phone:401-722-2400
Practice Address - Fax:401-728-3920
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI4148207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1780672709OtherORGANIZAITON NPI#
C90736Medicare UPIN