Provider Demographics
NPI:1467594887
Name:NEW ENGLAND RADIOLOGY & LAB SERVICES, P.C.
Entity Type:Organization
Organization Name:NEW ENGLAND RADIOLOGY & LAB SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-767-2036
Mailing Address - Street 1:25 JOHN A CUMMINGS WAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3224
Mailing Address - Country:US
Mailing Address - Phone:401-767-2036
Mailing Address - Fax:401-767-2037
Practice Address - Street 1:25 JOHN A CUMMINGS WAY
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3224
Practice Address - Country:US
Practice Address - Phone:401-767-2036
Practice Address - Fax:401-767-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255187OtherCIGNA
RI1467594Medicaid
RI32489OtherNEIGHBORHOOD HEALTH
AA107795OtherHPHC
662250OtherTUFTS
7627949OtherAETNA
=========OtherTRICARE
1255187OtherCIGNA
=========OtherUNITED HEATHCARE
AA107795OtherHPHC