MEDICARE: RHODE ISLAND WELLNESS CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1083501936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHODE ISLAND WELLNESS CLINIC

Provider Business Mailing Address
First Line	:	24 SALT POND RD STE B1
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4323
Country	:	US
Telephone Number	:	401-642-4051
Fax Number	:	401-642-5053

Provider Business Practice Location Address
First Line	:	24 SALT POND RD STE B1
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4323
Country	:	US
Telephone Number	:	617-780-9774
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	NEIMA HADI
Credential	:	MD
Telephone Number	:	401-642-4051

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	12/10/2025

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