| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 08/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558816330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD08003 (Rhode Island) | Primary |
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