Provider Demographics
NPI:1033323803
Name:MS CENTER OF CARE NEW ENGLAD
Entity Type:Organization
Organization Name:MS CENTER OF CARE NEW ENGLAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:RNP, MSN
Authorized Official - Phone:401-886-0629
Mailing Address - Street 1:25 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5712
Mailing Address - Country:US
Mailing Address - Phone:401-295-4181
Mailing Address - Fax:401-886-7084
Practice Address - Street 1:1351 S COUNTY TRL STE 200
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5080
Practice Address - Country:US
Practice Address - Phone:401-886-0629
Practice Address - Fax:401-886-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNP14381282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital