Healthcare Provider Details

I. General information

NPI: 1386195626
Provider Name (Legal Business Name): ORTHOPEDICS RHODE ISLAND, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 FRIENDSHIP ST
NEWPORT RI
02840-2209
US

IV. Provider business mailing address

11 FRIENDSHIP ST
NEWPORT RI
02840-2209
US

V. Phone/Fax

Practice location:
  • Phone: 401-789-1422
  • Fax: 401-515-4881
Mailing address:
  • Phone: 401-789-1422
  • Fax: 401-515-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY ELLEN ASHE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-789-1422