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General NPI Number Information
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NPI Number | 1699058826
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Entity Type | Organization
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Legal Business Name | SOUTHERN NEW ENGLAND HEALTHCARE FOR WOMEN, LLC
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 333 SCHOOL ST. SUITE 200
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City | PAWTUCKET
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State | RI
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Zip | 02860
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Country | US
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Telephone | 401-722-5033
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Fax | 401-722-5044
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Provider Business Mailing Address
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Address Line | 333 SCHOOL ST. SUITE 200
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City | PAWTUCKET
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State | RI
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Zip | 02860
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Country | US
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Telephone | 401-722-5033
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Fax | 401-722-5044
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Authorized Official
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Title or Position | CORPORATE ADMINISTRATIVE DIRECTOR
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Name | SANDY F COUTU
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Credential |
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Telephone | 401-722-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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