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
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