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Individual

BRIDGET M. WIECZKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
239 CRANSTON ST, PROVIDENCE, RI 02907-2406
(401) 444-0580
(401) 444-0428
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 780-2511
(401) 780-2565

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
17125
NH
208000000X
Pediatrics Physician
285507
NY
208000000X
Pediatrics Physician
Primary
MD17889
RI

Other

Enumeration date
04/25/2012
Last updated
07/02/2021
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