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Organization

GEORGE J JACEWICZ, M. D., INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE J JACEWICZ M.D. (OWNER)
(401) 738-6111
Entity
Organization

Contact information

Practice address
95 TOLL GATE RD, WARWICK, RI 02886-4443
(401) 738-6111
(401) 732-0155
Mailing address
95 TOLL GATE RD, WARWICK, RI 02886-4443
(401) 738-6111
(401) 732-0155

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4047
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GJ00045
RI
Enumeration date
10/10/2012
Last updated
09/06/2013
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