Individual
JEFFREY M BUROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-4500
Mailing address
PO BOX 3238, BOSTON, MA 02241-3238
(866) 689-8862
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD11229
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27982-4
BCBS RI
RI
01
—
412095
BLUECHIP
RI
05
—
7056846
—
RI
Enumeration date
01/07/2006
Last updated
05/22/2008
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