Organization
PRIMARY CARE MEDICAL ASSOCIATES OF CRANSTON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH G DEJESUS M.D. (MEDICAL DIRECTOR)
(401) 461-5400
Entity
Organization
Contact information
Practice address
1596 BROAD ST, CRANSTON, RI 02905-4130
(401) 461-5400
(401) 461-9039
Mailing address
1596 BROAD ST, CRANSTON, RI 02905-4130
(401) 461-5400
(401) 461-9039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10197
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2982
NEIGHBORHOOD HEALTH
RI
01
—
469187
TUFTS
RI
01
—
759600
ADVANTRA
RI
05
—
PC54016
—
RI
Enumeration date
01/01/2007
Last updated
03/01/2016
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