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Organization

SOUTHERN NEW ENGLAND WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA MELLO (AUTHORIZED OFFICIAL)
(508) 998-3041
Entity
Organization

Contact information

Practice address
60 S LAKE RD, TIVERTON, RI 02878-2830
(508) 998-3041
Mailing address
60 S LAKE RD, TIVERTON, RI 02878-2830
(508) 998-3041

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RP1001X
Pulmonary Disease Physician
207RS0012X
Sleep Medicine (Internal Medicine) Physician

Other

Enumeration date
05/15/2019
Last updated
05/15/2019
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