Provider Demographics
NPI:1588819445
Name:UROLOGIC SPECIALISTS OF NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:UROLOGIC SPECIALISTS OF NEW ENGLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAMBIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-828-7110
Mailing Address - Street 1:207 QUAKER LN
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-2179
Mailing Address - Country:US
Mailing Address - Phone:401-828-7110
Mailing Address - Fax:401-827-6364
Practice Address - Street 1:1539 ATWOOD AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3262
Practice Address - Country:US
Practice Address - Phone:401-828-7110
Practice Address - Fax:401-827-6364
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGIC SPECIALISTS OF NEW ENGLAND, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty