NPI 1396844544

Gateway Professional Group

Organisation Exclusive Provider Organization Providence, RI

Practice location

Address: 208 Governor St, Providence, RI 02906-3246
Phone: (401) 490-3563
Fax: (401) 490-3569

Authorised official

Name: Joyce a Facteau
Title: Credentialing Coordinator
Phone: (401) 724-8400

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Rhode Island →

Registry record

NPI: 1396844544
Entity type: Organization
NPI issued: 22 Sep 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.