Healthcare Provider Details
I. General information
NPI: 1730188327
Provider Name (Legal Business Name): SOUNDVIEW ORTHOPAEDIC ASSOC. LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2005
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 AIRPORT RD
WESTERLY RI
02891-3432
US
IV. Provider business mailing address
101 AIRPORT RD
WESTERLY RI
02891-3432
US
V. Phone/Fax
- Phone: 401-596-0259
- Fax: 401-348-5934
- Phone: 401-596-0259
- Fax: 401-348-5934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
R
GACCIONE
Title or Position: PARTNER
Credential: MD
Phone: 401-596-0259