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Organization
MEMORIAL HOSPITAL
Active
Organization
MEMORIAL HOSPITAL
Active
Parent organization
THE MEMORIAL HOSPITAL
Other names
Memorial Hospital EEG Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MEMORIAL HOSPITAL
Authorized official
MR. FRANCIS R DIETZ (CEO PRESIDENT)
(401) 729-2000
Entity
Organization
Contact information
Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 729-2000
Mailing address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 729-2000
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
Primary
—
NULL
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
04/25/2007
Last updated
11/30/2007
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