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219 Cass Ave Woonsocket RI 02895-4736 | |
| (401) 769-4100 | |
| (401) 766-9575 |
| Full Name | |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 219 Cass Ave, Woonsocket, Rhode Island |
| Authorized Official Name and Position | Stacy Viens (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4017694100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
219 Cass Ave Woonsocket RI 02895-4736 Ph: (401) 769-4100 | 219 Cass Ave Woonsocket RI 02895-4736 Ph: (401) 769-4100 |
| NPI Number | 1700207842 |
|---|---|
| Provider Enumeration Date | 12/16/2013 |
| Last Update Date | 01/11/2017 |
| Medicare PECOS PAC ID | 3274761069 |
|---|---|
| Medicare Enrollment ID | O20140414000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700207842 | NPI | - | NPPES |
| PR96418 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Margaret Ann Dicarlo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407874878 PECOS PAC ID: 0941220206 Enrollment ID: I20051203000070 |
| Provider Name | Keith W L Rafal |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1487755963 PECOS PAC ID: 3779666086 Enrollment ID: I20080211000166 |
| Provider Name | Deborah Beauvais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881877355 PECOS PAC ID: 7315024338 Enrollment ID: I20080401000703 |
| Provider Name | Joseph J Doerr |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1427052703 PECOS PAC ID: 7810939386 Enrollment ID: I20100319000527 |
| Provider Name | Mark Rosenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053412767 PECOS PAC ID: 9537053731 Enrollment ID: I20101027000167 |
| Provider Name | Peter D Covino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780062356 PECOS PAC ID: 2163730086 Enrollment ID: I20150925002330 |
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