Healthcare Provider Details

I. General information

NPI: 1841492071
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 RESERVOIR AVE SUITE 101
CRANSTON RI
02910
US

IV. Provider business mailing address

725 RESERVOIR AVE SUITE 101
CRANSTON RI
02910-4448
US

V. Phone/Fax

Practice location:
  • Phone: 401-944-3800
  • Fax: 401-944-1342
Mailing address:
  • Phone: 401-944-3800
  • Fax: 401-944-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberPHS00002
License Number StateRI

VIII. Authorized Official

Name: DR. AMEDEO LOUIS MARIORENZI
Title or Position: PRESIDENT
Credential: MD
Phone: 401-944-3800