Provider Demographics
NPI:1134694714
Name:CRITICAL CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:CRITICAL CARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-692-5292
Mailing Address - Street 1:15 MILLERS BROOK DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6158
Mailing Address - Country:US
Mailing Address - Phone:401-692-5292
Mailing Address - Fax:781-326-5950
Practice Address - Street 1:15 LITTLE BOOT LN
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2648
Practice Address - Country:US
Practice Address - Phone:401-692-5292
Practice Address - Fax:781-326-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Single Specialty