NPI: 1497220412 · PROVIDENCE, RI 02906 · Ambulatory Surgical Clinic/Center · NPI assigned 10/05/2018
| Authorized Official | LICHT, JONAH (OWNER) |
| NPI Enumeration Date | 10/05/2018 |
Other providers sharing the same authorized official: LICHT, JONAH
| Provider | City | State | Total Paid |
|---|---|---|---|
| PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC | PROVIDENCE | RI | $129K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 29 | $8K |
| 2022 | 16 | $352.45 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 36902 | 45 | 37 | $8K |