# PAUL E SYDLOWSKI MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659560902
- **Authorized official:** DR. PAUL EDMUND SYDLOWSKI M.D. (OWNER)
- **Authorized official phone:** (401) 253-4300

## Contact information

- **Practice address:** 576 METACOM AVE, UNIT 11A, BRISTOL, RI 02809-5100
- **Practice address phone:** (401) 253-4300
- **Practice address fax:** (401) 253-9217
- **Mailing address:** 576 METACOM AVE, UNIT 11A, BRISTOL, RI 02809-5100
- **Mailing address phone:** (401) 253-4300
- **Mailing address fax:** (401) 253-9217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 04705 | RI | Yes |

## Other

- **Enumeration date:** 10/22/2007
- **Last updated:** 10/22/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000026591 | BLUE SHIELD OF RHODE ISLA | RI |
| 01 | — | 740007 | TUFTS HEALTH PLAN | MA |
| 05 | — | PS50992 | — | RI |