Healthcare Provider Details

I. General information

NPI: 1700838281
Provider Name (Legal Business Name): BRIAN THOMAS RICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 ROUTE 134 SUITE C-2
SOUTH DENNIS MA
02660-3433
US

IV. Provider business mailing address

59 SHERIDAN ST
GLENS FALLS NY
12801-2625
US

V. Phone/Fax

Practice location:
  • Phone: 509-398-3617
  • Fax:
Mailing address:
  • Phone: 518-793-0492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number227193
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: