| NPI | 1285857219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER MENNILLO President 401-944-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: RI 09221) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: RI 03033) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |