Detrisac, Jennifer
Detrisac, Jennifer is an sole proprietor health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Detrisac, Jennifer can be contacted via phone (401) 444-4471.Contact Information
Primary practice address
593 Eddy St
Providence RI 02903-4923
Phone: (401) 444-4471
Fax: (401) 444-7574
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | LP02788 | Rhode Island |
Profile Details
| NPI number | 1891132916 |
|---|---|
| LBN Legal business name | Detrisac, Jennifer |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2013 |
| Last updated | Feb 22nd, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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