Organization
GARDEN CITY NEUROLOGY, LTD
Active
Organization
GARDEN CITY NEUROLOGY, LTD
Active
Other names
R.I. Neurodiagnostics & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LOUIS CERVONE M.D. (PRESIDENT)
(401) 714-0222
Entity
Organization
Contact information
Practice address
900 RESERVOIR AVE, CRANSTON, RI 02910-4417
(401) 714-0222
(401) 714-0220
Mailing address
900 RESERVOIR AVE, CRANSTON, RI 02910-4417
(401) 714-0222
(401) 714-0220
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
MD10970
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142223
FIRST HEALTH
RI
01
—
26655-2
BLUE CROSS RI NUMBER
RI
01
—
410755
BLUECHIP NUMBER
RI
01
—
4400009
UNITED HEALTH NUMBER
RI
05
—
GC51470
—
RI
Enumeration date
03/02/2007
Last updated
08/22/2020
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