Provider Demographics
NPI:1033380266
Name:SILK PHYSICAL THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:SILK PHYSICAL THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SILK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:401-274-4325
Mailing Address - Street 1:167 GANO ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3808
Mailing Address - Country:US
Mailing Address - Phone:401-274-4325
Mailing Address - Fax:401-274-0329
Practice Address - Street 1:167 GANO ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3808
Practice Address - Country:US
Practice Address - Phone:401-274-4325
Practice Address - Fax:401-274-0329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-15
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT00426261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIR004646OtherCHAMPUS
RI403696OtherBLUECHIP/COORDINATED H P
RI20202OtherNEIGHBORHOOD HEALTH PLAN
RI2517-9OtherBC & BS OF RHODE ISLAND
RI64-00069OtherUNITED HEALTH CARE