Provider Demographics
NPI:1629010988
Name:CHAD E. LAMENDOLA, M.D., LTD.
Entity Type:Organization
Organization Name:CHAD E. LAMENDOLA, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LAMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-884-5333
Mailing Address - Street 1:925 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3116
Mailing Address - Country:US
Mailing Address - Phone:401-884-5333
Mailing Address - Fax:401-884-5664
Practice Address - Street 1:925 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3116
Practice Address - Country:US
Practice Address - Phone:401-884-5333
Practice Address - Fax:401-884-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH07015Medicare UPIN