Individual
JACOB MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-6489
Mailing address
55 CLAVERICK ST FL 2, PROVIDENCE, RI 02903-4144
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD19979
RI
390200000X
Student in an Organized Health Care Education/Training Program
LP05356
RI
Other
Enumeration date
05/26/2021
Last updated
06/04/2025
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