Individual
DR. JAY M. BARUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 519-1604
(401) 272-0538
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2508
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD10404
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007060262
RI MEDICARE (UEMF)
RI
01
—
04/15/2009
UNITED HEALTHCARE
RI
01
—
10/30/2008
NHPRI
RI
01
—
12/29/2008
TUFTS HEALTH PLAN
MA
01
—
1619959581
NPI
RI
05
—
2152401
—
MA
01
—
25129-5
BCBSRI GROUP
RI
01
—
407365
BLUECHIP
RI
05
—
JB33017
—
RI
Enumeration date
11/23/2005
Last updated
08/04/2011
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