| Gasper Neurology, Ltd | |
|
900 Reservoir Ave Ste 1 Cranston RI 02910-4453 | |
| (401) 714-0222 | |
| (401) 714-0220 |
| Full Name | Gasper Neurology, Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 900 Reservoir Ave Ste 1, Cranston, Rhode Island |
| Authorized Official Name and Position | Mason Gasper (OWNER) |
| Authorized Official Contact | 4013780258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gasper Neurology, Ltd 900 Reservoir Ave Ste 1 Cranston RI 02910-4453 Ph: (401) 714-0222 | Gasper Neurology, Ltd 900 Reservoir Ave Ste 1 Cranston RI 02910-4453 Ph: (401) 714-0222 |
| NPI Number | 1629509641 |
|---|---|
| Provider Enumeration Date | 03/22/2017 |
| Last Update Date | 11/14/2019 |
| Medicare PECOS PAC ID | 7012272719 |
|---|---|
| Medicare Enrollment ID | O20180530001826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629509641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 00611 (Rhode Island) | Primary |
| Provider Name | Mason C Gasper |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245211788 PECOS PAC ID: 8729016027 Enrollment ID: I20061214000235 |
| Provider Name | Jessica M Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669800322 PECOS PAC ID: 0749419950 Enrollment ID: I20190930001682 |
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