Willow Street Medical Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WILLOW STREET MEDICAL LABORATORY LLC

Practice address

200 Main Street
Suite 220
Pawtucket, RI 02860

Phone

(401) 721-0970

Fax

(401) 721-9931

NPI assigned

Dec 17, 2007

Organization subpart

Yes

Parent organization

WILLOW STREET MEDICAL LABORATORY LLCAs reported in NPPES

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

Authorized official

Name

Brian J Strasnick, PHD JD

Title

Ceo President

Phone

(781) 268-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Willow Street Medical Lab LLC

Locations

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1366625071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAIN STREET",
            "address_2": "SUITE 220",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-721-0970",
            "fax_number": "401-721-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN STREET",
            "address_2": "SUITE 220",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-721-0970",
            "fax_number": "401-721-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW STREET MEDICAL LABORATORY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLOW STREET MEDICAL LABORATORY LLC",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "STRASNICK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "781-268-2400",
        "authorized_official_credential": "PHD JD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WS60052",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Williams, MASTERS
• Christine Lucene Williams, LICSW
• Edward Williams, MASTERS
• Robert Williams, MD
• Jane Mary Willis, LICSW
• Julie M Wilson, PH.D.
• Kar Wilson Jr.
• Janet Ann Wing, MSW
• Wise Self, LLC
• Cristina Carneglia Wise

• Clinical Medical Laboratory in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Clinical Medical Laboratory in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.