Provider Demographics
NPI:1710958830
Name:NORTH SMITHFIELD RADIOLOGY
Entity Type:Organization
Organization Name:NORTH SMITHFIELD RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNASTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-333-8090
Mailing Address - Street 1:63 EDDIE DOWLING HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7322
Mailing Address - Country:US
Mailing Address - Phone:401-333-8090
Mailing Address - Fax:
Practice Address - Street 1:63 EDDIE DOWLING HWY
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7322
Practice Address - Country:US
Practice Address - Phone:401-333-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G48556Medicare UPIN