Provider Demographics
NPI:1437034295
Name:PREVENTIVE CARDIOLOGY AND INTEGRATIVE WEIGHT LOSS LLC
Entity type:Organization
Organization Name:PREVENTIVE CARDIOLOGY AND INTEGRATIVE WEIGHT LOSS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-244-8335
Mailing Address - Street 1:2348 POST RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2271
Mailing Address - Country:US
Mailing Address - Phone:401-244-8335
Mailing Address - Fax:401-900-8003
Practice Address - Street 1:2348 POST RD STE 104
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2271
Practice Address - Country:US
Practice Address - Phone:401-244-8335
Practice Address - Fax:401-900-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-09
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty