Individual
POOYA JAHANSHAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7139
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7139
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
LP03163
RI
Other
Enumeration date
06/18/2013
Last updated
11/29/2021
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