Provider Demographics
NPI:1356965859
Name:BERGHELLI INTERNAL MEDICINE, LLC
Entity type:Organization
Organization Name:BERGHELLI INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGHELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-886-6000
Mailing Address - Street 1:2358 S COUNTY TRL
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1583
Mailing Address - Country:US
Mailing Address - Phone:401-886-6000
Mailing Address - Fax:401-886-6002
Practice Address - Street 1:2358 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1583
Practice Address - Country:US
Practice Address - Phone:401-886-6000
Practice Address - Fax:401-886-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care