NPIMap

Organization Active NPI

Governor Diagnostic and Treatment Center

  • Developmental - Behavioral Pediatrics Physician
  • Providence, RI
National Provider Identifier
1235439639
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
5984 Issued in RI
Legal business name
GOVERNOR DIAGNOSTIC AND TREATMENT CENTER
Practice address
293 Governor St
Providence, RI 02906-3220
Phone
(401) 351-5730
Fax
(401) 331-6260
NPI assigned
Nov 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Daniel Toby MarwilNPI 1417050055
Title
Sole Proprietor
Phone
(401) 351-5730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X 5984 RI Primary

Addresses

Primary practice location

293 Governor St
Providence, RI 02906-3220

Mailing address

293 Governor St
Providence, RI 02906-3220
Phone (401) 351-5730

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1235439639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063220",
            "telephone_number": "401-351-5730",
            "fax_number": "401-331-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063220",
            "telephone_number": "401-351-5730",
            "fax_number": "401-331-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOVERNOR DIAGNOSTIC AND TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "MARWIL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "TOBY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "401-351-5730",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "RI",
            "license": "5984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.