BAYSIDE OB/GYN INC. NPI 1780718056

NPI Information

BAYSIDE OB/GYN, INC. is a clinic center in Providence, RI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BAYSIDE OB/GYN, INC. NPI is 1780718056. The provider is registered as an organization entity type.

The provider's business location address is:

235 PLAIN ST
201
PROVIDENCE, RI
ZIP 02905-240
Phone: (401) 421-1710
Fax: (401) 861-2164

The provider's authorized official is Claudia A Iacobbo .
The authorized official title is Practice Manager and has the following contact phone number (401) 421-1710.

The CLIA number assigned to this NPI record is 41D0083879 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/16/2007 and was last updated on 1/7/2008.

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:

Other Identifiers

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

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