Individual
JEREMY KULACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 606-2513
(401) 444-6858
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 606-2513
(401) 444-6858
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
LP03105
RI
Other
Enumeration date
05/28/2014
Last updated
10/16/2020
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