Organization
COASTAL MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERYL MOSS (COO)
(401) 421-4000
Entity
Organization
Contact information
Practice address
900 WARREN AVE, STE 401, EAST PROVIDENCE, RI 02914-1430
(401) 421-4000
Mailing address
10 DAVOL SQ, STE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/12/2017
Last updated
03/26/2019
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