Individual
DR. JEFFREY RIESE
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) 444-7396
(401) 444-7502
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7396
(401) 444-7502
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD13981
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD13981
LICENSE
RI
Enumeration date
06/26/2009
Last updated
03/26/2013
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