Healthcare Provider Details

I. General information

NPI: 1811168164
Provider Name (Legal Business Name): UROLOGIC SPECIALISTS OF NEW ENGLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 QUAKER LN 1ST FLOOR
WEST WARWICK RI
02893-2179
US

IV. Provider business mailing address

207 QUAKER LN FL 1
WEST WARWICK RI
02893-2179
US

V. Phone/Fax

Practice location:
  • Phone: 401-828-7110
  • Fax: 401-827-6364
Mailing address:
  • Phone: 401-828-7110
  • Fax: 401-827-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberPHS00004
License Number StateRI

VIII. Authorized Official

Name: ASHLEY M PERRAS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 401-381-1227