| NPI | 1043213754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARQUIS Billing Manager 401-762-0020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI RAD0090) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: RI RAD0090) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2011-09-28 |