Organization
WOODRIDGE MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY JEAN POTENZA (OFFICE MANAGER)
(401) 943-1860
Entity
Organization
Contact information
Practice address
351 BUDLONG RD, CRANSTON, RI 02920-6001
(401) 943-1860
(401) 943-8952
Mailing address
351 BUDLONG RD, CRANSTON, RI 02920-6001
(401) 943-1860
(401) 943-8952
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
80110112683
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000049
—
RI
05
—
9000168
—
RI
05
—
9020788
—
RI
Enumeration date
08/19/2006
Last updated
08/22/2020
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