Edgewood Medical LLC

NPI #1952501421 in Cranston, Rhode Island

Provider Information

NPI Number: 1952501421
Entity Type: Organization
Organization Name: Edgewood Medical LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 23, 2007
Last Updated: Sep 9, 2008

Practice Location

Address: 251 PARK AVE
Address 2: 2ND FLOOR
City: Cranston
State: Rhode Island
ZIP Code: 02905-2647
Phone: (401) 275-0700

Authorized Official

Name: DR. JOSE R POLANCO, MD
Title: MEDICAL DIRECTOR
Phone: (401) 275-0700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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