Organization
GENESIS ELDER CARE PHYSICIAN SERVICES LLC
Active
Organization
GENESIS ELDER CARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET JEAN BAKER (DIR OF BUS OPS)
(410) 494-7607
Entity
Organization
Contact information
Practice address
660 COMMONWEALTH AVENUE, WARWICK, RI 02886-2707
(401) 739-4241
(401) 732-3358
Mailing address
PO BOX 42738, TOWSON, MD 21284-2738
(860) 687-3629
(860) 687-3622
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
NPP37084
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9004790
—
RI
Enumeration date
05/09/2006
Last updated
04/12/2018
Update your record
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