| Carol L Baum-gupta, | |
| 
					555 Prospect Street, Pawtucket, RI 02860  | |
| (401) 729-6200 | |
| (401) 729-6203 | 
| Full Name | Carol L Baum-gupta | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics - Developmental - Behavioral Pediatrics | 
| Location | 555 Prospect Street, Pawtucket, Rhode Island | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598922809 | NPI | - | NPPES | 
| CB85575 | Medicaid | RI | |
| 002284501 | Other | RI | MEDICARE PTAN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | MD12633 (Rhode Island) | Primary | 
| Entity Name | Pratt Pediatric Associates Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1477590511 PECOS PAC ID: 3779475371 Enrollment ID: O20040329000127  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Carol L Baum-gupta, 111 Brewster Street, Wood Bldg #516, Pawtucket, RI 02860 Ph: () -  | Carol L Baum-gupta, 555 Prospect Street, Pawtucket, RI 02860 Ph: (401) 729-6200  | 
Natalia Lukankina, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-6200  | |
Tanya Jean Becker, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 126 Prospect St, Pawtucket, RI 02860 Phone: 401-728-9206 Fax: 401-722-6960  | |
Viren Andrew D'sa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 555 Prospect St, Pawtucket, RI 02860 Phone: 401-729-6200 Fax: 401-729-6203  | |
Esther J. Entin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 111 Brewster St, Department Of Pediatrics, Pawtucket, RI 02860 Phone: 401-729-6200 Fax: 401-729-6203  | |
Kunjbala Sharma, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1145 Main St, Pawtucket, RI 02860 Phone: 401-722-0081 Fax: 401-312-0318  | |
Cameron Elizabeth Walker Lang, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 39 East Ave, Pawtucket, RI 02860 Phone: 401-722-0081 Fax: 401-312-0318  |