1578507943 NPI number — NEW ENGLAND ORTHOPEDICS, INC

Table of content: (NPI 1578507943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578507943 NPI number — NEW ENGLAND ORTHOPEDICS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND ORTHOPEDICS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578507943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 TOLL GATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-4418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-739-9838
Provider Business Mailing Address Fax Number:
401-738-5669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 TOLL GATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02886-4418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-739-9838
Provider Business Practice Location Address Fax Number:
401-738-5669
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
INFANTOLINO
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MGR
Authorized Official Telephone Number:
401-739-9838

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30011469 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 617110 . This is a "CIGNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1539264 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5595439 . This is a "AETNA/USHEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 9009642 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9642-3 . This is a "BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 200295 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 98862001 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2963 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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