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General NPI Number Information
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NPI Number | 1649206277
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Entity Type | Organization
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Legal Business Name | BALD HILL PEDIATRICS
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 BALD HILL RD SUITE 501
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City | WARWICK
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State | RI
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Zip | 02886-1617
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Country | US
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Telephone | 401-732-5437
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Fax | 401-732-5095
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Provider Business Mailing Address
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Address Line | 400 BALD HILL RD SUITE 501
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City | WARWICK
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State | RI
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Zip | 02886-1617
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Country | US
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Telephone | 401-732-5437
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Fax | 401-732-5095
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MARILYN BOICHAT
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Credential |
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Telephone | 401-732-5437
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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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