Healthcare Provider Details

I. General information

NPI: 1871588046
Provider Name (Legal Business Name): ENZER & ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 DUDLEY ST SUITE 104
PROVIDENCE RI
02905-2436
US

IV. Provider business mailing address

120 DUDLEY ST SUITE 104
PROVIDENCE RI
02905-2436
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-4464
  • Fax: 401-831-0710
Mailing address:
  • Phone: 401-274-4464
  • Fax: 401-831-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number7280
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number7280
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number7280
License Number StateRI

VIII. Authorized Official

Name: DR. YOASH R ENZER
Title or Position: PRESIDENT
Credential: MD
Phone: 401-274-4464