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JENNIFER DETRISAC M.D.
NPI 1891132916
Pediatrics in Providence, RI

Active since May 30, 2013
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-4471(401) 444-7574 Get Directions Write a Review

NPPES record last updated: February 22, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jennifer Detrisac M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER DETRISAC M.D. (NPI 1891132916) is an individual pediatrics provider in Providence, Rhode Island, licensed in Rhode Island (LP02788) and active in the NPI registry since May 2013.

NPPES Registry Identity

NPI1891132916
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJENNIFER DETRISACCredential: M.D.
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-4471 · Fax (401) 444-7574
Phone(401) 444-4471
Fax(401) 444-7574
Sole ProprietorYes
Enumeration DateMay 30, 2013
Last NPPES UpdateFebruary 22, 2016
✔ NPI 1891132916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in RI · LP02788
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
593 EDDY ST, Providence, RI 02903
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRIAN CAO MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-4286
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Detrisac's NPI number?

The NPI number for Jennifer Detrisac is 1891132916. It was assigned to this individual provider in the NPPES registry on May 30, 2013.

Where is Jennifer Detrisac located?

Jennifer Detrisac practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-4471.

What is Jennifer Detrisac's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Jennifer Detrisac was last updated on February 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.