Provider Demographics
NPI:1780007575
Name:SOUTHEASTERN NEW ENGLAND DIAGNOSTIC SERVICES, INC
Entity Type:Organization
Organization Name:SOUTHEASTERN NEW ENGLAND DIAGNOSTIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-467-6210
Mailing Address - Street 1:1030 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3655
Mailing Address - Country:US
Mailing Address - Phone:401-467-6210
Mailing Address - Fax:
Practice Address - Street 1:1030 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3655
Practice Address - Country:US
Practice Address - Phone:401-467-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty