| NPI | 1255104584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET TWEEDY Billing Manager 401-379-1224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-05-06 |