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Individual

JONAH M LICHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 HIGHLAND AVE, PROVIDENCE, RI 02906
(401) 277-9729
(401) 277-9730
Mailing address
100 HIGHLAND AVE, PROVIDENCE, RI 02906-2740
(401) 277-9729
(401) 277-9730

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD12125
RI
207RN0300X
Nephrology Physician
Primary
MD12125
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134192
RI
Enumeration date
02/10/2006
Last updated
06/13/2025
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