Healthcare Provider Details

I. General information

NPI: 1689733990
Provider Name (Legal Business Name): CAT SCANNING OF NORTH PROVIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 MINERAL SPRING AVENUE
NORTH PROVIDENCE RI
02904
US

IV. Provider business mailing address

1725 MENDON ROAD SUITE 207
CUMBERLAND RI
02864
US

V. Phone/Fax

Practice location:
  • Phone: 401-354-6093
  • Fax:
Mailing address:
  • Phone: 401-334-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES ROSENTHAL
Title or Position: PRESIDENT
Credential: MD
Phone: 401-354-6093