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EASTSIDE NEUROLOGY INC. NPI 1407079643


NPI Information

NPI: 1407079643
Provider Name: EASTSIDE NEUROLOGY, INC.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 41D0083868

Address:
450 VETERANS MEMORIAL PKWY
BUILDING 11
EAST PROVIDENCE, RI
ZIP 02914
Phone: (401) 431-1860
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EASTSIDE NEUROLOGY, INC. is a neurology psychiatry neurology in East Providence, RI. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. EASTSIDE NEUROLOGY, INC. NPI is 1407079643. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

450 VETERANS MEMORIAL PKWY
BUILDING 11
EAST PROVIDENCE, RI
ZIP 02914-300
Phone: (401) 431-1860
Fax: (401) 435-0328

The provider's authorized official is Norman Mervyn Gordon .
The authorized official title is President and has the following contact phone number (401) 431-1860.

The CLIA number assigned to this NPI record is 41D0083868 - independent with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology7343RHODE ISLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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