Organization
PAUL E SYDLOWSKI MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL EDMUND SYDLOWSKI M.D. (OWNER)
(401) 253-4300
Entity
Organization
Contact information
Practice address
576 METACOM AVE, UNIT 11A, BRISTOL, RI 02809-5100
(401) 253-4300
(401) 253-9217
Mailing address
576 METACOM AVE, UNIT 11A, BRISTOL, RI 02809-5100
(401) 253-4300
(401) 253-9217
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04705
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000026591
BLUE SHIELD OF RHODE ISLA
RI
01
—
740007
TUFTS HEALTH PLAN
MA
05
—
PS50992
—
RI
Enumeration date
10/22/2007
Last updated
10/22/2007
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