| Organization Name: | ANCHOR MEDICAL ASSOCIATES |
| NPI Number: | 1205832029 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NATHAN B BERAHA (MEDICAL DIRECTOR) |
| Mailing Address: | 1 Hoppin St Ste 3 Providence |
| State: | RI US |
| Postal Code: | 029034141 |
| Phone Number: | 4017938400 |
| Fax Number: | 4017938402 |
| NPI Enumeration Date: | 06/27/2005 |
| NPI Last Update Date: | 11/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |