| NPI | 1609005958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J BERGERON Practice Manager 401-946-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI DO 00582) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |