Provider Demographics
NPI:1134242472
Name:RHODE ISLAND FOOT CARE, INC
Entity type:Organization
Organization Name:RHODE ISLAND FOOT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-305-3800
Mailing Address - Street 1:649 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6157
Mailing Address - Country:US
Mailing Address - Phone:401-305-3800
Mailing Address - Fax:401-305-3816
Practice Address - Street 1:649 EAST AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6157
Practice Address - Country:US
Practice Address - Phone:401-305-3800
Practice Address - Fax:401-305-3816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0860OtherNEIGHBORHOOD HEALTH PLAN
RI13195Medicaid
RI604423OtherTUFTS
RI0536612OtherAETNA
RI2642-0OtherBLUE CROSS BLUE SHIELD
RI0536612OtherAETNA
RICF9981Medicare PIN
RI489002642Medicare ID - Type Unspecified