Healthcare Provider Details
I. General information
NPI: 1477883825
Provider Name (Legal Business Name): NEW ENGLAND MEDICAL OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
469 CENTERVILLE RD SUITE 102
WARWICK RI
02886-4354
US
IV. Provider business mailing address
469 CENTERVILLE RD SUITE 102
WARWICK RI
02886-4354
US
V. Phone/Fax
- Phone: 401-889-2300
- Fax: 401-739-2300
- Phone: 401-889-2300
- Fax: 401-739-2300
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 11705 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 11706 |
| License Number State | RI |
VIII. Authorized Official
Name: DR.
RAFAEL
ARBUES
TORRES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 401-632-6123