| NPI | 1225543754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ZUBA General Manager 401-626-2748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |