Healthcare Provider Details

I. General information

NPI: 1205893955
Provider Name (Legal Business Name): PRIMARY CARDIOLOGY OF ATTLEBORO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 EMORY ST
ATTLEBORO MA
02703-2439
US

IV. Provider business mailing address

75 NEWMAN AVE SUITE 100
RUMFORD RI
02916-3603
US

V. Phone/Fax

Practice location:
  • Phone: 508-699-3079
  • Fax: 508-809-9552
Mailing address:
  • Phone: 401-453-0666
  • Fax: 401-435-7019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RANDAL B KAUFMAN
Title or Position: OWNER
Credential: MD
Phone: 508-699-1025