Healthcare Provider Details

I. General information

NPI: 1053101238
Provider Name (Legal Business Name): PRECISION NEUROLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DUDLEY ST STE 2
PROVIDENCE RI
02905-3236
US

IV. Provider business mailing address

115 NORWOOD PARK S STE 106
NORWOOD MA
02062-4633
US

V. Phone/Fax

Practice location:
  • Phone: 781-352-4777
  • Fax: 781-352-4778
Mailing address:
  • Phone: 781-352-4777
  • Fax: 781-352-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY CARL RODRIGUES
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 781-352-4777