East Side Primary Care Providence Llc | |
1195 N Main St Providence RI 02904-1824 | |
(401) 334-3105 | |
(401) 334-1144 |
Full Name | East Side Primary Care Providence Llc |
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Speciality | Internal Medicine |
Location | 1195 N Main St, Providence, Rhode Island |
Authorized Official Name and Position | Frank M D'alessandro (OWNER) |
Authorized Official Contact | 4015788816 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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East Side Primary Care Providence Llc 1195 N Main St Providence RI 02904-1824 Ph: (401) 334-3105 | East Side Primary Care Providence Llc 1195 N Main St Providence RI 02904-1824 Ph: (401) 334-3105 |
NPI Number | 1558816330 |
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Provider Enumeration Date | 08/22/2016 |
Last Update Date | 08/22/2016 |
Identifier | Type | State | Issuer |
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1558816330 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD08003 (Rhode Island) | Primary |
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