Provider Demographics
NPI:1962440545
Name:PARTNERS IN OBSTETRICS AND GYNECOLOGY
Entity Type:Organization
Organization Name:PARTNERS IN OBSTETRICS AND GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOMAGALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-724-0600
Mailing Address - Street 1:333 SCHOOL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5334
Mailing Address - Country:US
Mailing Address - Phone:401-724-0600
Mailing Address - Fax:401-724-8306
Practice Address - Street 1:333 SCHOOL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5334
Practice Address - Country:US
Practice Address - Phone:401-724-0600
Practice Address - Fax:401-724-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002529Medicaid
462648OtherAETNA
RI2020OtherNEIGHBORHOOD HEALTH
RI2529OtherBLUE CROSS
608658OtherTUFTS HEALTH