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General NPI Number Information
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NPI Number | 1104544949
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Entity Type | Organization
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Legal Business Name | VA HOSPITAL
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 830 CHALKSTONE AVE
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City | PROVIDENCE
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State | RI
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Zip | 02908-4734
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Country | US
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Telephone | 401-273-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 409 HOPE ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-1634
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Country | US
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Telephone | 401-378-4801
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MR. ZHEN-MING MATTHEW FENG
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Credential | RN
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Telephone | 401-378-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number |
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License Number State |
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