| NPI | 1558551069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MARIE TETREAULT Practice Manager 401-742-5965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 150014) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2023-11-27 |