Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD08540 | RI |
N | 207V00000X | Obstetrician & Gynecologist | MD08540 | RI |
N | 2086X0206X | Surgical Oncologist | MD08540 | RI |
NPI | 1225065139 |
---|---|
Provider Name | Jennifer Gass |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 17/12/2021 |