Provider Demographics
NPI:1346427325
Name:NEW ENGLAND PAIN ASSOCIATES
Entity Type:Organization
Organization Name:NEW ENGLAND PAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FATHALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-490-2130
Mailing Address - Street 1:42 HEMINGWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895
Mailing Address - Country:US
Mailing Address - Phone:401-490-2130
Mailing Address - Fax:
Practice Address - Street 1:25 JOHN CUMMINGS WAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-767-2525
Practice Address - Fax:401-767-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPHS0007261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI414034OtherBCBS RI
RI5728-2OtherBLUE CHIP
RI1134753OtherAETNA
RI490001011Medicare PIN