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General NPI Number Information
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NPI Number | 1629367537
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Entity Type | Individual
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Provider Name | JENNIFER PINHANCOS PA
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Gender | Female
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 2 DUDLEY ST SUITE 200
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City | PROVIDENCE
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State | RI
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Zip | 02905-3236
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Country | US
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Telephone | 401-626-3913
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Fax | 401-861-5812
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Provider Business Mailing Address
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Address Line | PO BOX 1119
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City | PROVIDENCE
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State | RI
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Zip | 02901-1119
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Country | US
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Telephone | 401-626-3913
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Fax | 401-861-5812
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00587
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 587
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA5075
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License Number State | MA
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