Healthcare Provider Details

I. General information

NPI: 1811039449
Provider Name (Legal Business Name): OCEAN STATE PAIN MANAGEMENT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 CASS AVE SUITE B
WOONSOCKET RI
02895-4741
US

IV. Provider business mailing address

219 CASS AVE SUITE 1
WOONSOCKET RI
02895-4741
US

V. Phone/Fax

Practice location:
  • Phone: 401-333-6100
  • Fax: 401-333-6900
Mailing address:
  • Phone: 401-766-1600
  • Fax: 401-766-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABDUL BARAKAT
Title or Position: PRESIDENT
Credential: MD
Phone: 401-333-6100