Provider Demographics
NPI:1427355791
Name:NRI PEDIATRICS PC
Entity type:Organization
Organization Name:NRI PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNSTEIN-BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-334-5437
Mailing Address - Street 1:2140 MENDON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3833
Mailing Address - Country:US
Mailing Address - Phone:401-334-5437
Mailing Address - Fax:401-334-3571
Practice Address - Street 1:2140 MENDON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3833
Practice Address - Country:US
Practice Address - Phone:401-334-5437
Practice Address - Fax:401-334-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD123012080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty