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General NPI Number Information
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NPI Number | 1801287933
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Entity Type | Individual
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Provider Name | ALAN EZOVSKI LICSW
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Gender | Male
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 105 WEST SHORE ROAD
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City | WARWICK
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State | RI
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Zip | 02889
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Country | US
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Telephone | 401-527-3102
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 POST ROAD, UNIT #5
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City | EAST GREENWICH
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State | RI
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Zip | 02818
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Country | US
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Telephone | 401-787-4089
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW00948
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License Number State | RI
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