Healthcare Provider Details

I. General information

NPI: 1184766008
Provider Name (Legal Business Name): TOLL GATE PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 TOLL GATE RD SUITE 104
WARWICK RI
02886-4458
US

IV. Provider business mailing address

215 TOLL GATE RD SUITE 104
WARWICK RI
02886-4458
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-9240
  • Fax: 401-739-6413
Mailing address:
  • Phone: 401-737-9240
  • Fax: 401-739-6413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID J HUNT
Title or Position: PRESIDENT
Credential: D.O.
Phone: 401-737-9240