| Memorial Hospital Eeg Group | |
|
111 Brewster St Pawtucket RI 02860-4400 | |
| (401) 729-2000 | |
| Not Available |
| Full Name | Memorial Hospital Eeg Group |
|---|---|
| Speciality | Psychiatry & Neurology - Diagnostic Neuroimaging |
| Location | 111 Brewster St, Pawtucket, Rhode Island |
| Authorized Official Name and Position | Francis R Dietz (CEO PRESIDENT) |
| Authorized Official Contact | 4017292000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Hospital Eeg Group 111 Brewster St Pawtucket RI 02860-4400 Ph: (401) 729-2000 | Memorial Hospital Eeg Group 111 Brewster St Pawtucket RI 02860-4400 Ph: (401) 729-2000 |
| NPI Number | 1386863496 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386863496 | NPI | - | NPPES |
| 9006134 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084D0003X | Psychiatry & Neurology - Diagnostic Neuroimaging | (* (Not Available)) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
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