Individual
GEORGE J. JACEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
08/23/2005
Last updated
07/08/2007
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