Provider Demographics
NPI:1376589895
Name:UNIVERSITY SURGICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:UNIVERSITY SURGICAL ASSOCIATES, INC.
Other - Org Name:BROWN SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, FINANCIAL OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-854-2444
Mailing Address - Street 1:PO BOX 16149
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-0697
Mailing Address - Country:US
Mailing Address - Phone:401-453-9625
Mailing Address - Fax:401-435-7069
Practice Address - Street 1:2 DUDLEY ST STE 470
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3248
Practice Address - Country:US
Practice Address - Phone:401-272-1800
Practice Address - Fax:401-751-5124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRI04030Medicaid
MA0016073Medicare PIN
RI709003530Medicare PIN