Provider Demographics
NPI:1184942930
Name:PRIMARY CARE OF BARRINGTON LLC
Entity type:Organization
Organization Name:PRIMARY CARE OF BARRINGTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SADOVNIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-289-2961
Mailing Address - Street 1:60 BAY SPRING AVE
Mailing Address - Street 2:UNIT A1
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1384
Mailing Address - Country:US
Mailing Address - Phone:401-289-2961
Mailing Address - Fax:401-289-2963
Practice Address - Street 1:60 BAY SPRING AVE
Practice Address - Street 2:UNIT A1
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1384
Practice Address - Country:US
Practice Address - Phone:401-289-2961
Practice Address - Fax:401-289-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty