MEDICARE: NORTH SMITHFIELD RADIOLOGY

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1710958830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SMITHFIELD RADIOLOGY

Provider Business Mailing Address
First Line	:	63 EDDIE DOWLING HWY
Second Line	:
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-7322
Country	:	US
Telephone Number	:	401-333-8090
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 EDDIE DOWLING HWY
Second Line	:
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-7322
Country	:	US
Telephone Number	:	401-333-8090
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID GUNASTI
Credential	:	MD
Telephone Number	:	401-333-8090

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	08/22/2020

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