Individual
DR. JESSICA CONLON MANYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
67 SLADES FERRY AVE STE 6706, SOMERSET, MA 02726-1220
(508) 678-5633
(508) 673-5605
Mailing address
7 HOMESTEAD ST, PAWTUCKET, RI 02860-4215
(401) 837-4503
(508) 673-5605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0538
RI
207Q00000X
Family Medicine Physician
Primary
283425
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JM50782
—
RI
Enumeration date
07/01/2005
Last updated
05/19/2022
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