Organization
TOLL GATE RADIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY G BRUZZESE MD (PRESIDENT)
(401) 738-3100
Entity
Organization
Contact information
Practice address
300 TOLL GATE RD, STE 101A, STE 102, WARWICK, RI 02886-4416
(401) 738-3100
(401) 738-8505
Mailing address
215 TOLL GATE RD, STE 109, WARWICK, RI 02886-4458
(401) 738-3100
(401) 738-8505
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
RAD0066
RI
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
RAD0066
RI
2085N0700X
Neuroradiology Physician
RAD0066
RI
2085N0904X
Nuclear Radiology Physician
RAD0066
RI
2085P0229X
Pediatric Radiology Physician
RAD0066
RI
2085R0202X
Diagnostic Radiology Physician
Primary
RAD0066
RI
2085R0204X
Vascular & Interventional Radiology Physician
RAD0066
RI
2085U0001X
Diagnostic Ultrasound Physician
RAD0066
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1198-5
BCBS OFFICE PROVIDER NO
RI
01
—
1570-5
BCBS KENT HOSP PROVIDER N
RI
01
—
1742251
UNITED HEALTHCARE
RI
01
—
2188604
AETNA OFFICE PROVIDER NO
RI
01
—
2203
NEIGHBORHOOD H PLAN PROVI
RI
01
—
50356624
UNICARE LIFE AND HLTH INS
RI
01
—
5144133
AETNA KENT HOSPITAL PROV
RI
01
—
68453
CIGNA
RI
01
—
703058
TUFTS HEALTH PLAN
RI
05
—
9001198
—
RI
05
—
9001570
—
RI
01
—
CD2379
RAILROAD MEDICARE
RI
Enumeration date
08/09/2006
Last updated
12/16/2008
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