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General NPI Number Information
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NPI Number | 1285611285
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Entity Type | Organization
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Legal Business Name | NORTHERN RI REHAB MANAGEMENT ASSOCIATES LP
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 116 EDDIE DOWLING HWY
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City | NORTH SMITHFIELD
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State | RI
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Zip | 02896-7327
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Country | US
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Telephone | 401-766-0800
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Fax | 401-762-3112
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Provider Business Mailing Address
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Address Line | 196 CASS AVE
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City | WOONSOCKET
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State | RI
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Zip | 02895-4712
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Country | US
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Telephone | 401-769-4100
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Fax | 401-765-6024
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN WALLBANK
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Credential |
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Telephone | 401-766-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 02102
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License Number State | RI
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