Provider Demographics
NPI:1285839142
Name:BAYSIDE ENDOCRINOLOGY INC
Entity Type:Organization
Organization Name:BAYSIDE ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-737-1485
Mailing Address - Street 1:470 TOLL GATE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2741
Mailing Address - Country:US
Mailing Address - Phone:401-737-1485
Mailing Address - Fax:
Practice Address - Street 1:470 TOLL GATE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2741
Practice Address - Country:US
Practice Address - Phone:401-737-1485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty