JENNIFER DETRISAC

PROVIDENCE, RI
NPI1891132916
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy208000000X Pediatrics
(Licence: RI  LP02788)
Enumeration Date2013-05-30
Last Update Date2016-02-22
Business Address
JENNIFER DETRISAC M.D.
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4471
Mailing Address
JENNIFER DETRISAC M.D.
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4471