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General NPI Number Information
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NPI Number | 1407718323
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Entity Type | Individual
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Provider Name | JORGE LUIS RESENDIZ BSN, RN
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Gender | Male
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 57 POWER RD
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City | CRANSTON
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State | RI
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Zip | 02920-3046
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Country | US
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Telephone | 401-462-7234
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Fax |
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Provider Business Mailing Address
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Address Line | 152 FINCH AVE
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City | PAWTUCKET
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State | RI
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Zip | 02860-2418
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Country | US
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Telephone | 857-413-8128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN69709
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License Number State | RI
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