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General NPI Number Information
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NPI Number | 1013726520
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Entity Type | Organization
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Legal Business Name | NORTH SMITHFIELD FOOT AND ANKLE, INC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 249 EDDIE DOWLING HWY
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City | NORTH SMITHFIELD
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State | RI
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Zip | 02896-8213
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Country | US
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Telephone | 401-769-5611
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Fax | 401-769-6238
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Provider Business Mailing Address
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Address Line | 345 ARMISTICE BLVD
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City | PAWTUCKET
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State | RI
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Zip | 02861-2429
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Country | US
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Telephone | 401-725-5576
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Fax | 401-725-2640
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH DOMENICO
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Credential | DPM
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Telephone | 401-725-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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