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10 Dorrance St Ste 700 Providence RI 02903-2014 | |
(203) 598-6045 | |
(203) 879-0834 |
Full Name | |
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Speciality | General Practice |
Location | 10 Dorrance St Ste 700, Providence, Rhode Island |
Authorized Official Name and Position | Jonathan Brenes (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 2035986045 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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76 Batterson Park Rd Ste 106 Farmington CT 06032-2571 Ph: () - | 10 Dorrance St Ste 700 Providence RI 02903-2014 Ph: (203) 598-6045 |
NPI Number | 1881211738 |
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Provider Enumeration Date | 06/26/2020 |
Last Update Date | 10/23/2023 |
Medicare PECOS PAC ID | 0042614331 |
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Medicare Enrollment ID | O20210809002918 |
Identifier | Type | State | Issuer |
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1881211738 | NPI | - | NPPES |
Provider Name | Nicole K Breting |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023488145 PECOS PAC ID: 1456652015 Enrollment ID: I20151228000053 |
Provider Name | Sujit Michael Ray |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1336469592 PECOS PAC ID: 3779724554 Enrollment ID: I20210809002841 |
Provider Name | Amy L Wright |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1831540327 PECOS PAC ID: 5092008797 Enrollment ID: I20230612001144 |
Provider Name | Brianna Putnam |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932715356 PECOS PAC ID: 8527417856 Enrollment ID: I20240429000485 |
Kevin E. Baill Md & Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 Blackstone Blvd, Providence, RI 02906 Phone: 917-447-2138 | |
Ocean State Urgent Care At St Joseph Health Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Peace St, Providence, RI 02907 Phone: 301-314-3999 Fax: 401-808-6294 | |
Theodore C. Palumbo, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 Staniford St, Providence, RI 02905 Phone: 401-421-8800 Fax: 401-273-6510 | |