NPI 1003982547 · live from the CMS NPI Registry
Heritage Medical Associates PC
Internal Medicine in Pawtucket, RI. National Provider Identifier 1003982547, active.
NPI record
| NPI | 1003982547 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 131 Beechwood Ave, Pawtucket, RI 02860 |
| Practice phone | 401-475-1999 |
| Enumerated | November 27, 2006 |
| Last updated | October 13, 2015 |
| Authorized official | John Miskovsky, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | CT 0816 (CT) |
| Internal Medicine primary | 207R00000X | MD 10350 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.