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ROGER WILLIAMS RADIATION THERAPY LLC NPI 1013078450


NPI Information

NPI: 1013078450
Provider Name: ROGER WILLIAMS RADIATION THERAPY, LLC
Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

CLIA Number: 41D0663777

Address:
50 MAUDE ST
PROVIDENCE, RI
ZIP 02908
Phone: (401) 456-2690
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ROGER WILLIAMS RADIATION THERAPY, LLC is a radiation oncology radiology in Providence, RI. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. ROGER WILLIAMS RADIATION THERAPY, LLC NPI is 1013078450. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

50 MAUDE ST
PROVIDENCE, RI
ZIP 02908-325
Phone: (401) 456-2690
Fax: (401) 456-6540

The provider's authorized official is Shaden Marzouk .
The authorized official title is President and has the following contact phone number (239) 931-7254.

The CLIA number assigned to this NPI record is 41D0663777 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 9/25/2023.


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
12085R0001XRadiologyRadiation OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11013078MEDICAIDRHODE ISLAND

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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