Organization
BROWN MEDICINE
Active
Organization
BROWN MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA GORDON (RCM DIRECTOR)
(401) 443-5107
Entity
Organization
Contact information
Practice address
375 WAMPANOAG TRL, RIVERSIDE, RI 02915-2232
(401) 649-4020
(401) 649-4021
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 537-7241
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
05/20/2022
Last updated
01/18/2024
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