Organization
BAYSIDE ENDOSCOPY CENTER, LLC
Active
Other names
BAYSIDE ENDOSCOPY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
33 STANIFORD ST, PROVIDENCE, RI 02905-3105
(401) 274-1810
(401) 273-9689
Mailing address
33 STANIFORD ST, PROVIDENCE, RI 02905-3105
(401) 274-1810
(401) 273-9689
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
FAS01011
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9411003
—
RI
Enumeration date
07/07/2005
Last updated
02/08/2023
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