Individual
JESSIE ANDOSCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 CRANSTON ST, CRANSTON, RI 02920-5038
(401) 223-0230
Mailing address
1700 CRANSTON ST, CRANSTON, RI 02920-5038
(401) 223-0230
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PTA01271
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PTA01271
—
RI
Enumeration date
06/01/2020
Last updated
06/01/2020
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