Provider Demographics
NPI:1609061175
Name:DRS LAMPAL AND MONTGOMERY
Entity Type:Organization
Organization Name:DRS LAMPAL AND MONTGOMERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-761-3155
Mailing Address - Street 1:207 WATERMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4381
Mailing Address - Country:US
Mailing Address - Phone:401-861-3155
Mailing Address - Fax:
Practice Address - Street 1:207 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4381
Practice Address - Country:US
Practice Address - Phone:401-861-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD3488208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILM06882Medicaid