Healthcare Provider Details

I. General information

NPI: 1467594887
Provider Name (Legal Business Name): NEW ENGLAND RADIOLOGY & LAB SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 JOHN A CUMMINGS WAY
WOONSOCKET RI
02895-3224
US

IV. Provider business mailing address

25 JOHN A CUMMINGS WAY 2ND FLOOR
WOONSOCKET RI
02895-3224
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-2036
  • Fax: 401-767-2037
Mailing address:
  • Phone: 401-767-2036
  • Fax: 401-767-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HISHAM ELKADI
Title or Position: OWNER
Credential: M.D.
Phone: 401-767-2036