Organization
NEUROSURGERY FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN MATESANZ (PRACTICE ADMINISTRATOR)
(401) 490-4143
Entity
Organization
Contact information
Practice address
55 CLAVERICK ST, PROVIDENCE, RI 02903-4144
(401) 490-4162
Mailing address
55 CLAVERICK ST, PROVIDENCE, RI 02903-4144
(401) 490-4162
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
12/23/2005
Last updated
08/22/2020
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