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General NPI Number Information
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NPI Number | 1184713646
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Entity Type | Organization
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Legal Business Name | EGP INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1377 S COUNTY TRL SUITE 2B
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City | EAST GREENWICH
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State | RI
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Zip | 02818-5082
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Country | US
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Telephone | 401-884-8900
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Fax | 401-884-9199
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Provider Business Mailing Address
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Address Line | 1377 S COUNTY TRL SUITE 2B
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City | EAST GREENWICH
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State | RI
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Zip | 02818-5082
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Country | US
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Telephone | 401-884-8900
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Fax | 401-884-9199
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DIANE M DICOLA
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Credential |
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Telephone | 401-884-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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