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Organization
PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
Active
Organization
PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAH LICHT M.D. (OWNER)
(401) 277-9729
Entity
Organization
Contact information
Practice address
100 HIGHLAND AVE STE 100, PROVIDENCE, RI 02906-2740
(401) 277-9729
(401) 277-9730
Mailing address
100 HIGHLAND AVE STE 100, PROVIDENCE, RI 02906-2740
(401) 277-9729
(401) 277-9730
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
11/03/2011
Last updated
06/13/2025
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