1609960590 NPI number — UROLOGIC SURGEONS OF NEW ENGLAND, P.C.

Table of content: (NPI 1609960590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609960590 NPI number — UROLOGIC SURGEONS OF NEW ENGLAND, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UROLOGIC SURGEONS OF NEW ENGLAND, P.C.
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:
1609960590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 CORLISS ST
Provider Second Line Business Mailing Address:
2ND LEVEL
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02904-2611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-274-6565
Provider Business Mailing Address Fax Number:
401-331-2370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 CORLISS ST
Provider Second Line Business Practice Location Address:
2ND LEVEL
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02904-2611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-274-6565
Provider Business Practice Location Address Fax Number:
401-331-2370
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENZONI
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
401-861-8400

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10059 . This is a "NHP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 25692 . This is a "BCBS RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 008242 . This is a "TUFTS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0004673110 . This is a "AETNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0007759013 . This is a "AETNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1087 . This is a "NHP GROUP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 27125 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 27180 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: AA51691 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 005102 . This is a "TUFTS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1900145 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1900147 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 797515 . This is a "TUFTS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 10058 . This is a "NHP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1900216 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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