| The Stone Center | |
|
164 Summit Ave 2rd Floor Fain Building Providence RI 02906-2853 | |
| (401) 793-2919 | |
| Not Available |
| Full Name | The Stone Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 164 Summit Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Peter K Markell (EVP & CFO) |
| Authorized Official Contact | 4014447914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Stone Center 117 Ellenfield St Providence RI 02905-4513 Ph: (401) 444-5640 | The Stone Center 164 Summit Ave 2rd Floor Fain Building Providence RI 02906-2853 Ph: (401) 793-2919 |
| NPI Number | 1669726451 |
|---|---|
| Provider Enumeration Date | 11/01/2012 |
| Last Update Date | 04/21/2023 |
| Medicare PECOS PAC ID | 6901796408 |
|---|---|
| Medicare Enrollment ID | O20130430000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669726451 | NPI | - | NPPES |
| 1669726451 | Other | RI | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | HOS00122 (Rhode Island) | Primary |
| Provider Name | John W Obell |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982657805 PECOS PAC ID: 6103712922 Enrollment ID: I20040918000013 |
| Provider Name | Gyan Pareek |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376654350 PECOS PAC ID: 9436125028 Enrollment ID: I20050520000048 |
| Provider Name | Simone Thavaseelan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053530782 PECOS PAC ID: 2668641945 Enrollment ID: I20110802000527 |
| Provider Name | Jie Tang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1871583997 PECOS PAC ID: 0749246098 Enrollment ID: I20151019000199 |
| Provider Name | Mary Anne Gaffney |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508166851 PECOS PAC ID: 5698132306 Enrollment ID: I20230611000084 |
| Provider Name | Sarah Ogawa |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417735440 PECOS PAC ID: 0244680791 Enrollment ID: I20231222002684 |
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