| NPI | 1154807717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ZUBA Director Of Operations 401-626-2748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |