Organization
EAST BAY COUNSLING CENTER, INC..
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD NELSON GAVALYA. MD M. D. (DIRECTOR)
(401) 728-3400
Entity
Organization
Contact information
Practice address
77 BEECHWOOD AVE, PAWTUCKET, RI 02860-5409
(401) 728-3400
(401) 724-3990
Mailing address
77 BEECHWOOD AVE, PAWTUCKET, RI 02860-5409
(401) 728-3400
(401) 724-3990
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
RIMD4323
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30095-1
BCBS
RI
Enumeration date
10/20/2006
Last updated
09/23/2010
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