Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD11338 | RI |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 272741 | MA |
NPI | 1508863432 |
---|---|
Provider Name | Jennifer Mcinnes Ritzau |
First Address | Providence, RI 02908-4728 |
Second Address | Providence, RI 02908-4728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 31/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7050186 | (05) | RI |
H76387 | (02) | RI |