Pavinarmatha Ketheeswaran, MD
Family Medicine in Providence, Rhode Island
1962066878- Practice location
- 40 Candace St, Providence, RI 02908-3747
- Phone
- 401-444-0550
- Fax
- 401-444-0425
- Last updated
- July 8, 2026
Pavinarmatha Ketheeswaran is a Family Medicine based in Providence, RI. Pavinarmatha Ketheeswaran practices in Providence, RI and has the professional credentials of MD. The NPI Number for Pavinarmatha Ketheeswaran is 1962066878 and holds a License No. LP04636 (RI). The current practice location address for Pavinarmatha Ketheeswaran is 40 Candace St, Providence, RI 02908-3747 and can be reached out via phone at 401-444-0550 and via fax at 401-444-0425.
Provider Profile Details
- NPI Number
- 1962066878
- Provider Name
- Pavinarmatha Ketheeswaran
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 40 Candace St, Providence, RI 02908-3747
- Phone Number
- 401-444-0550
- Fax Number
- 401-444-0425
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 25, 2019
- Last Update Date
- July 8, 2026
- Certification Date
- July 8, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 40 Candace St
Providence, RI 02908-3747 - City
- Providence
- State
- Rhode Island
- Zip
- 02908-3747
- Phone Number
- 401-444-0550
- Fax Number
- 401-444-0425
Provider Business Mailing Address Details
- Address
- 375 Allens Ave
Providence, RI 02905-5010 - City
- Providence
- State
- RI
- Zip
- 02905-5010
- Phone Number
- 401-444-0400
- Fax Number
- 401-444-0468
License Information
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (2)
- LP04636
- License State (2)
- RI
- Taxonomy (2)
- Family Medicine · 207Q00000X
- License Number (3)
- ME179335
- License State (3)
- FL
- Taxonomy (3)
- Family Medicine · 207Q00000X · Primary
- License Number (4)
- MD18615
- License State (4)
- RI
- Taxonomy (4)
- Family Medicine · 207Q00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Pavinarmatha Ketheeswaran, MD?
The NPI number of Pavinarmatha Ketheeswaran, MD is 1962066878. It was assigned on April 25, 2019 and is currently active in the NPPES registry.
What is the specialty of Pavinarmatha Ketheeswaran, MD?
Pavinarmatha Ketheeswaran, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in RI under license number LP04636.
Where does Pavinarmatha Ketheeswaran, MD practice?
The practice location is 40 Candace St, Providence, RI 02908-3747. The office can be reached at 401-444-0550 (phone) or 401-444-0425 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1962066878 directly on the NPPES registry website.