| NPI | 1649445545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA SOSA Payer Credentialing Specialist 401-921-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center, Emergency Care |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2024-09-12 |