Provider Demographics
NPI:1285664524
Name:PRIMA INC
Entity Type:Organization
Organization Name:PRIMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MONTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-333-5201
Mailing Address - Street 1:2178 MENDON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864
Mailing Address - Country:US
Mailing Address - Phone:401-333-5201
Mailing Address - Fax:401-333-5215
Practice Address - Street 1:2178 MENDON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864
Practice Address - Country:US
Practice Address - Phone:401-333-5201
Practice Address - Fax:401-333-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty