BAYSIDE ENDOSCOPY CENTER, LLC; NPI #1720085657

Contact Information

BAYSIDE ENDOSCOPY CENTER, LLC

33 STANIFORD ST
PROVIDENCE, RI 02905-3105

Phone: 401-274-1810
Fax: 401-273-9689
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for BAYSIDE ENDOSCOPY CENTER, LLC

NPI Number 1720085657

LBN Legal business name BAYSIDE ENDOSCOPY CENTER, LLC

Authorized official JENNIFER BALDOCK - (OFFICER AND AUTHORIZED OFFICIAL)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/07/2005

Last updated 02/08/2023 - About 3 years ago

Identifiers

RI	License #	FAS01011
RI	Medicaid	9411003

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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