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General NPI Number Information
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NPI Number | 1922036946
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Entity Type | Organization
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Legal Business Name | ATLANTIC PROFESSIONAL SERVICES OF RHODE ISLAND INCORPORATED
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 100 KENYON AVENUE
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City | WAKEFIELD
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State | RI
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Zip | 02879-4299
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Country | US
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Telephone | 401-782-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 635998
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City | CINCINNATI
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State | OH
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Zip | 45263-5998
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DAVID ISTVAN
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Credential | M.D.
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Telephone | 518-842-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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