| Broadway Medical Treatment Center, Llc | |
|
1053 S Broadway East Providence RI 02914-4729 | |
| (401) 438-5551 | |
| (401) 438-7272 |
| Full Name | Broadway Medical Treatment Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1053 S Broadway, East Providence, Rhode Island |
| Authorized Official Name and Position | Peter George Brassard (PHYSICIAN / OWNER) |
| Authorized Official Contact | 4014385551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Medical Treatment Center, Llc 1053 S Broadway East Providence RI 02914-4729 Ph: (401) 438-5551 | Broadway Medical Treatment Center, Llc 1053 S Broadway East Providence RI 02914-4729 Ph: (401) 438-5551 |
| NPI Number | 1104010032 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 09/04/2007 |
| Medicare PECOS PAC ID | 0648175364 |
|---|---|
| Medicare Enrollment ID | O20031204000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104010032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | CMD 06972 (Rhode Island) | Primary |
| Provider Name | Peter George Brassard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609877489 PECOS PAC ID: 4981509619 Enrollment ID: I20040212000637 |
Alex Mandel, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Massasoit Ave, Suite 300, East Providence, RI 02914 Phone: 401-434-8226 Fax: 401-434-4178 | |
East Providence Senior Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Waterman Ave, East Providence, RI 02914 Phone: 401-435-7800 Fax: 401-435-7803 | |
Dr Michael C Souza, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2761 Pawtucket Ave, East Providence, RI 02914 Phone: 401-434-3350 Fax: 401-434-5230 | |
Daniela Turacova Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 525 Taunton Avenue, Suite 100, East Providence, RI 02914 Phone: 401-438-0888 | |
Dsmt At East Providence Senior Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Waterman Ave, East Providence, RI 02914 Phone: 401-435-7800 Fax: 401-435-7803 | |
Primary Medical Center And Walk-in Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 684 Warren Ave, East Providence, RI 02914 Phone: 401-434-0022 Fax: 401-434-6111 |