Provider Demographics
NPI:1942757208
Name:GYNCARE INC
Entity Type:Organization
Organization Name:GYNCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MD
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERMUDEZ-EMMANUELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-223-2920
Mailing Address - Street 1:235 PLAIN ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3240
Mailing Address - Country:US
Mailing Address - Phone:216-201-0991
Mailing Address - Fax:
Practice Address - Street 1:235 PLAIN ST
Practice Address - Street 2:SUITE 307
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:216-201-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-04
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty