Organization
PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
Active
Other names
Providence Access Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAH LICHT MD (OWNER)
(401) 277-9729
Entity
Organization
Contact information
Practice address
100 HIGHLAND AVE STE 100, PROVIDENCE, RI 02906-2740
(401) 277-9729
(401) 277-9730
Mailing address
100 HIGHLAND AVE STE 100, PROVIDENCE, RI 02906-2740
(401) 277-9729
(401) 277-9730
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497220412
—
RI
Enumeration date
10/05/2018
Last updated
06/13/2025
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