Individual
JENNIFER A SCRUGGS-BENASSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
593 EDDY ST, MAIN BLDG., ROOM 038, PROVIDENCE, RI 02903-4923
(401) 444-4779
(401) 444-7464
Mailing address
593 EDDY ST, MAIN BLDG., ROOM 038, PROVIDENCE, RI 02903-4923
(401) 444-4779
(401) 444-7464
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD13774
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JS97086
—
RI
Enumeration date
07/09/2008
Last updated
07/01/2014
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