| Andrew Marc Tareila, MD | |
|
593 Eddy St, Providence, RI 02903-4923 | |
| (401) 444-5127 | |
| (401) 444-3056 |
| Full Name | Andrew Marc Tareila |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 593 Eddy St, Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891288627 | NPI | - | NPPES |
| LP04344 | Other | RI | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD17185 (Rhode Island) | Primary |
| Entity Name | Lgh Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174698385 PECOS PAC ID: 3173626751 Enrollment ID: O20070320000453 |
| Entity Name | Merrimack Radiology-cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275871154 PECOS PAC ID: 8426287269 Enrollment ID: O20140128000095 |
| Entity Name | Mw Radiology-cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114555398 PECOS PAC ID: 6406270040 Enrollment ID: O20200716000148 |
| Entity Name | Tmc Radiology Cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851046726 PECOS PAC ID: 4486041746 Enrollment ID: O20220505000580 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Marc Tareila, MD 125 Metro Center Blvd, Warwick, RI 02886-1768 Ph: (401) 432-2500 | Andrew Marc Tareila, MD 593 Eddy St, Providence, RI 02903-4923 Ph: (401) 444-5127 |
Lars Stangenberg, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2 Dudley St, Suite 470, Providence, RI 02905 Phone: 401-553-8318 Fax: 401-868-2307 | |
Kara Lynne Leonard, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Rih Radiation Oncology, Providence, RI 02903 Phone: 401-444-8311 Fax: 401-444-5335 | |
Paul S Rava, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8311 | |
Earle O Assanah, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5174 | |
Glenn A Tung, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-4000 | |
Dr. John Charles Mach, DO Radiology Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-432-2500 | |
Sarah-kim Shields, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Radiology, Providence, RI 02903 Phone: 401-444-2133 Fax: 401-444-5017 |