| Michael S Siclari, MD | |
|
111 Brewster Street, Pawtucket, RI 02860-4400 | |
| (401) 729-2419 | |
| (401) 729-2517 |
| Full Name | Michael S Siclari |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 111 Brewster Street, Pawtucket, 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 |
|---|---|---|---|
| 1033226444 | NPI | - | NPPES |
| 939025129 | Other | RI | RI MEDICARE GROUP NUMBER |
| 7002026 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | MD06991 (Rhode Island) | Primary |
| Entity Name | Brown Emergency Medicine |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962455022 PECOS PAC ID: 7214833169 Enrollment ID: O20040116000868 |
| Entity Name | Blackstone Valley Community Health Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063574135 PECOS PAC ID: 8628045762 Enrollment ID: O20040916000775 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael S Siclari, MD 111 Brewster Street, Wood Bldg #516, Pawtucket, RI 02860-4400 Ph: (401) 729-3481 | Michael S Siclari, MD 111 Brewster Street, Pawtucket, RI 02860-4400 Ph: (401) 729-2419 |
John Riedel, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster St, Department Of Emergency Medicine, Pawtucket, RI 02860 Phone: 401-729-2191 Fax: 401-729-2517 | |
James P O'hair, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 100 Smithfield Ave, Pawtucket, RI 02860 Phone: 401-725-8600 Fax: 401-725-8064 | |
Laura Forman, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-2191 | |
Marcia Robitaille, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 111 Brewster St, Department Of Emergency Medicine, Pawtucket, RI 02860 Phone: 401-729-2191 Fax: 401-729-2517 | |
Dr. Kristin Lynch Gregg, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster Street, Pawtucket, RI 02860 Phone: 401-729-2419 | |
Amir Bernaba, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-2419 Fax: 401-729-2517 |