Provider Demographics
NPI:1821216029
Name:ATWOOD PEDIATRICS
Entity Type:Organization
Organization Name:ATWOOD PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GENNARO
Authorized Official - Middle Name:
Authorized Official - Last Name:PASQUARIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-274-2910
Mailing Address - Street 1:1524 ATWOOD AVE SUITE 110
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-247-2910
Mailing Address - Fax:401-274-8907
Practice Address - Street 1:1524 ATWOOD AVE STE 110
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-247-2910
Practice Address - Fax:401-274-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty