Individual
LIONEL G BERCOVITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY STREET,, APC-10, PROVIDENCE, RI 02903
(401) 444-7959
(401) 444-7144
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD05283
RI
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
36392
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962473314
—
RI
Enumeration date
02/01/2006
Last updated
03/10/2026
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