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General NPI Number Information
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NPI Number | 1396903399
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Entity Type | Organization
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Legal Business Name | TRI COUNTY UROLOGY, LLC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 176 TOLL GATE ROAD SUITE 301
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City | WARWICK
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State | RI
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Zip | 02886-4411
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Country | US
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Telephone | 401-739-2984
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Fax | 401-739-0867
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Provider Business Mailing Address
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Address Line | 176 TOLL GATE ROAD SUITE 301
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City | WARWICK
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State | RI
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Zip | 02886-4411
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Country | US
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Telephone | 401-739-2984
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Fax | 401-739-0867
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DOREEN UCCI
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Credential |
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Telephone | 401-739-2984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | RI00487
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0487
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | DO00487
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License Number State | RI
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