Healthcare Provider Details

I. General information

NPI: 1427381052
Provider Name (Legal Business Name): EMERGENCY PHYSICIAN ASSOCIATES OF NEW ENGLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KENYON AVE
WAKEFIELD RI
02879-4216
US

IV. Provider business mailing address

307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US

V. Phone/Fax

Practice location:
  • Phone: 401-782-8000
  • Fax:
Mailing address:
  • Phone: 856-686-4316
  • Fax: 856-848-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateRI

VIII. Authorized Official

Name: DR. ANTHONY R. GIORGIO
Title or Position: PRESIDENT
Credential: MD
Phone: 856-686-4394