Gateway Professional Group
NPI #1396844544 in Providence, Rhode Island
Provider Information
- NPI Number
- 1396844544
- Entity Type
- Organization
- Organization Name
- Gateway Professional Group
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Sep 22, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 208 GOVERNOR ST
- City
- Providence
- State
- Rhode Island
- ZIP Code
- 02906-3246
- Phone
- (401) 490-3563
Authorized Official
- Name
- JOYCE A FACTEAU
- Title
- CREDENTIALING COORDINATOR
- Phone
- (401) 724-8400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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