Iannuccilli, Jason
Iannuccilli, Jason is an sole proprietor health care provider with primary practice located at 125 Metro Center Blvd Ste 2000 , Warwick RI 02886-1785. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Iannuccilli, Jason can be contacted via phone (401) 432-2520.Contact Information
Primary practice address
125 Metro Center Blvd Ste 2000
Warwick RI 02886-1785
Phone: (401) 432-2520
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD12595 | Rhode Island |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | A111724 | California |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | LP00021 | Rhode Island |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 12595 | Rhode Island |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 12595 | Rhode Island |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD12595 | Rhode Island |
Profile Details
| NPI number | 1659599868 |
|---|---|
| LBN Legal business name | Iannuccilli, Jason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 23rd, 2007 |
| Last updated | Mar 18th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659599868 | NPPES |
| Rhode Island | MEDICAID | J185324 | |
| Rhode Island | MEDICAID | 0A1117240 |
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