Provider Demographics
NPI:1669557914
Name:KRENSAVAGE CORPORATION
Entity type:Organization
Organization Name:KRENSAVAGE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THADDEUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRENSAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-683-4300
Mailing Address - Street 1:2444 E MAIN RD
Mailing Address - Street 2:SUITE 3R
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4025
Mailing Address - Country:US
Mailing Address - Phone:401-683-4300
Mailing Address - Fax:401-683-4303
Practice Address - Street 1:2444 E MAIN RD
Practice Address - Street 2:SUITE 3R
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4025
Practice Address - Country:US
Practice Address - Phone:401-683-4300
Practice Address - Fax:401-683-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO380207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty