Individual
DR. STEPHANIE JO PENCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN
Contact information
Practice address
41 SANDERSON RD STE 202, SMITHFIELD, RI 02917-2603
(401) 231-3138
(401) 231-4757
Mailing address
41 SANDERSON RD STE 202, SMITHFIELD, RI 02917
(401) 231-3138
(401) 231-4757
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD08739
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73004
STATE LICENCE
MA
01
—
MD08739
STATE LICENSE
RI
05
—
SP40427
—
RI
Enumeration date
12/04/2006
Last updated
03/07/2023
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