Jennifer Detrisac
M.D. | Pediatrics | Female
Jennifer Detrisac, M.D. is a Providence, Rhode Island based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Jennifer Detrisac is
593 Eddy St, Providence, Rhode Island - 02903-4923. She can be contacted on phone at
401-444-4471 and fax number 401-444-7574.
Jennifer Detrisac is a sole proprietor of her business.
NPI number (Unique professional ID) for Jennifer Detrisac is
1891132916 which was assigned by NPPES on 30 May, 2013 and it was last updated on 22 Feb, 2016.
Jennifer Detrisac license number is
LP02788 for Pediatrics (208000000X) in Rhode Island.
Jennifer Detrisac is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Jennifer Detrisac basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Jennifer Detrisac |
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| Credential : | M.D. |
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| Gender : | Female |
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| Sole Proprietor : | Yes |
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Business Address:
Jennifer Detrisac address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 593 Eddy St
Providence, RI, 02903-4923
United States |
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| Phone Number : | 401-444-4471 |
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| Fax Number : | 401-444-7574 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1891132916 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 30 May, 2013 |
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| Last Updated On : | 22 Feb, 2016 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jennifer Detrisac are as mentioned. Primary taxonomy code for Jennifer Detrisac, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | LP02788 | RI |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 593 Eddy St
Providence, RI, 02903-4923
United States |
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| Phone Number : | 401-444-4471 |
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| Fax Number : | 401-444-7574 |
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Business Location:
Patients can refer following map for directions to
Jennifer Detrisac practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.