Organization
BROWN NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA L DOMINGOS (CREDENTIALING SPECIALIST)
(401) 443-5122
Entity
Organization
Contact information
Practice address
593 EDDY STREET, APC 5, PROVIDENCE, RI 02903
(401) 444-3032
(401) 444-3205
Mailing address
110 ELM ST FL 1, PROVIDENCE, RI 02903-4626
(401) 444-7016
(401) 444-3205
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366486102
—
RI
05
—
NF07469
—
RI
Enumeration date
06/15/2006
Last updated
05/22/2025
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