1952840381 NPI number — NEW ENGLAND PREMIER HEALTHCARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952840381 NPI number — NEW ENGLAND PREMIER HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND PREMIER HEALTHCARE
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:
1952840381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
343 4TH AVE
Provider Second Line Business Mailing Address:
APT 10A
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11215-2719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-996-5267
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
262 POPLAR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOONSOCKET
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02895-3747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-996-5267
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2017

Additional Information

Authorized Official

Authorized Official Last Name:
LAMP
Authorized Official First Name:
GARRON
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
401-996-5267

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  MD15142 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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