Healthcare Provider Details

I. General information

NPI: 1063534790
Provider Name (Legal Business Name): MEETING STREET CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 EDDY STREET
PROVIDENCE RI
02905
US

IV. Provider business mailing address

1000 EDDY STREET
PROVIDENCE RI
02905
US

V. Phone/Fax

Practice location:
  • Phone: 401-533-9100
  • Fax:
Mailing address:
  • Phone: 401-533-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LYNNE MALONE
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 401-533-9100