Sai Aishwarya Bosula, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Providence, RI
NPI 1467201194 · NPPES record last updated Jun 3, 2024
Key facts
- NPI
- 1467201194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- CLP06269 (RI)
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 793-2695
- Fax
- (401) 444-4165
- NPI assigned
- May 15, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241202001412 | RI | Order and Referring Only - Internal Medicine |
4082149943 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CLP06269 | RI | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CLP06269 | RI | Yes |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
593 Eddy St
Providence, RI 02903-4923
Phone (401) 793-2695
Other names
- Aisha Bosula
Other providers in Providence, RI
- Michael Anthony Bossi
- Andrew Bostom
- Sonya Bostom
- Boston Brace International Inc.
- Boston Therapy Inc
- Boswell, Inc.
- Carol Louise Botelho
- Charlene Beth Botelho
- Kristi Ann Botelho
- Nancy M Botelho
All providers in Providence, RI · Student in an Organized Health Care Education/Training Program in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.