Healthcare Provider Details

I. General information

NPI: 1710958830
Provider Name (Legal Business Name): NORTH SMITHFIELD RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 EDDIE DOWLING HWY
NORTH SMITHFIELD RI
02896-7322
US

IV. Provider business mailing address

63 EDDIE DOWLING HWY
NORTH SMITHFIELD RI
02896-7322
US

V. Phone/Fax

Practice location:
  • Phone: 401-333-8090
  • Fax:
Mailing address:
  • Phone: 401-333-8090
  • 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: DAVID GUNASTI
Title or Position: OWNER
Credential: MD
Phone: 401-333-8090