| NPI | 1730827767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA GORDON Rcm Director 401-443-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 213ES0131X Podiatrist Foot Surgery | |
| 363AM0700X Physician Assistant Medical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2024-01-18 |