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General NPI Number Information
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NPI Number | 1922664317
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY THERAPEUTICS PC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 340 BROADWAY
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City | PROVIDENCE
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State | RI
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Zip | 02909-1102
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Country | US
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Telephone | 401-451-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 59 HIGHLAND RD
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City | BRISTOL
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State | RI
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Zip | 02809-1443
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Country | US
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Telephone | 401-451-9758
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. RENDUELES VILLALBA II
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Credential | MD
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Telephone | 401-451-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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