Healthcare Provider Details

I. General information

NPI: 1518269760
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2010
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2138 MENDON RD SUITE 302
CUMBERLAND RI
02864
US

IV. Provider business mailing address

725 RESERVOIR AVE
CRANSTON RI
02910-4448
US

V. Phone/Fax

Practice location:
  • Phone: 401-334-1060
  • Fax:
Mailing address:
  • Phone: 401-944-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateRI

VIII. Authorized Official

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