| Jennifer Kim, MD, JD, MHA | |
|
593 Eddy Street Main Bldg Rm 038, Providence, RI 02903 | |
| (401) 444-4779 | |
| Not Available |
| Full Name | Jennifer Kim |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 593 Eddy Street Main Bldg Rm 038, Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700375870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD18556 (Rhode Island) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
| Entity Name | Lifespan Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548506793 PECOS PAC ID: 2567455082 Enrollment ID: O20130528000089 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Kim, MD, JD, MHA 117 Ellenfield St Ste 101, Providence, RI 02905-4541 Ph: (401) 444-6779 | Jennifer Kim, MD, JD, MHA 593 Eddy Street Main Bldg Rm 038, Providence, RI 02903 Ph: (401) 444-4779 |
Dr. Dana Siperstein, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 167 Point St, Providence, RI 02903 Phone: 401-793-8808 Fax: 401-793-8851 | |
Giuseppe Salvatore D'amelio Iv, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 35 S Angell St Ste 8, Providence, RI 02906 Phone: 401-753-8821 | |
Eugenie Atallah, Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-606-2645 Fax: 401-606-4386 | |
Dr. Luisa Skoble, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5448 Fax: 401-444-6119 | |
Arnaldo A Berges, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Jane Brown 5s, Providence, RI 02903 Phone: 401-444-5448 Fax: 401-444-6119 | |
Sharath Ponnappa Puttichanda, Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 345 Blackstone Blvd, Providence, RI 02906 Phone: 401-455-6346 Fax: 401-455-6532 | |
Loreen Phyllis Carol Pirnie, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5448 |