Healthcare Provider Details

I. General information

NPI: 1245233824
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 CENTERVILLE RD SUITE 103
WARWICK RI
02886-4354
US

IV. Provider business mailing address

38 HAMLET AVE
WOONSOCKET RI
02895-4423
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-9002
  • Fax: 401-732-4167
Mailing address:
  • Phone: 401-762-0020
  • Fax: 401-762-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberSRF0068
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberSRF0068
License Number StateRI

VIII. Authorized Official

Name: LISA MARQUIS
Title or Position: BILLING MANAGER
Credential:
Phone: 401-762-0020