Active NPI
Paul E Sydlowski MD LLC
- Ophthalmology Physician
- Bristol, RI
National Provider Identifier
1659560902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 04705
- Legal business name
- PAUL E SYDLOWSKI MD LLC
- Practice address
- 576 Metacom Ave
Unit 11a
Bristol, RI 02809-5100 - Phone
- (401) 253-4300
- Fax
- (401) 253-9217
- NPI assigned
- Oct 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Paul Edmund Sydlowski, M.D.
- Title
- Owner
- Phone
- (401) 253-4300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 04705 | RI | Primary |
Addresses
Primary practice location
576 Metacom Ave
Unit 11a
Bristol, RI 02809-5100
Mailing address
576 Metacom Ave
Unit 11a
Bristol, RI 02809-5100
Phone (401) 253-4300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS50992 | Medicaid | RI | |
| 740007 | Other | MA | TUFTS HEALTH PLAN |
| 0000026591 | Other | RI | BLUE SHIELD OF RHODE ISLA |
National Provider Directory
National Provider DirectoryLocations
576 Metacom Ave
Ste 11A
Bristol, RI 02809
Phone (401) 253-4300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193011200000",
"number": "1659560902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 METACOM AVE",
"address_2": "UNIT 11A",
"city": "BRISTOL",
"state": "RI",
"postal_code": "028095100",
"telephone_number": "401-253-4300",
"fax_number": "401-253-9217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 METACOM AVE",
"address_2": "UNIT 11A",
"city": "BRISTOL",
"state": "RI",
"postal_code": "028095100",
"telephone_number": "401-253-4300",
"fax_number": "401-253-9217"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL E SYDLOWSKI MD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-22",
"last_updated": "2007-10-22",
"status": "A",
"authorized_official_last_name": "SYDLOWSKI",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "EDMUND",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "401-253-4300",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "RI",
"license": "04705",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS50992",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "740007",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF RHODE ISLA",
"identifier": "0000026591",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.