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NPI Code Detail

MEDICARE: NORTHERN RI REHAB MANAGEMENT ASSOCIATES LP

MEDICARE: NORTHERN RI REHAB MANAGEMENT ASSOCIATES LP
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
1207U00000XNuclear Medicine Physician02102RI
2207UN0901XNuclear Cardiology Physician02102RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000006789OTHERRIBLUE SHIELD/BLUE CHIP
2903936OTHERMATUFTS HEALTH PLAN (IP)
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306823307
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHERN RI REHAB MANAGEMENT ASSOCIATES LP
Provider Business Mailing Address
First Line : 196 CASS AVE
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-4712
Country : US
Telephone Number : 401-769-4100
Fax Number : 401-765-6024
Provider Business Practice Location Address
First Line : 116 EDDIE DOWLING HWY
Second Line :
City : NORTH SMITHFIELD
State : RI
Zip : 02896-7327
Country : US
Telephone Number : 401-766-0800
Fax Number : 401-762-3112
Authorized Official
Title or Position : CFO
Name : STEPHEN WALLBANK
Credential :
Telephone Number : 401-766-0800
Provider Enumeration Date : 12/30/2005
Last Update Date : 09/11/2025

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Directions to “NORTHERN RI REHAB MANAGEMENT ASSOCIATES LP ” Practice Location

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