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General NPI Number Information
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NPI Number | 1821216029
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Entity Type | Organization
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Legal Business Name | ATWOOD PEDIATRICS
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1524 ATWOOD AVE STE 110
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City | JOHNSTON
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State | RI
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Zip | 02919-3228
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Country | US
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Telephone | 401-247-2910
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Fax | 401-274-8907
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Provider Business Mailing Address
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Address Line | 1524 ATWOOD AVE SUITE 110
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City | JOHNSTON
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State | RI
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Zip | 02919
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Country | US
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Telephone | 401-247-2910
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Fax | 401-274-8907
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GENNARO PASQUARIELLO
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Credential | MD
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Telephone | 401-274-2910
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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 | RI
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