-- JACK R BEVIVINO -- MD
Individual Provider (NPI-1)
Active
Plastic Surgery
Provider Information
- NPI Number
1780705707- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 120 DUDLEY STREET SUITE #201, PROVIDENCE, RI, 029052431
- Phone
- (401) 521-9290
- Fax
- (401) 521-9297
Specialties & Taxonomies
Plastic Surgery
Primary License: RI #RIMD05259