Graduated: 1992
Offers telehealth
NPI: 1700119062
Practice Locations (2)
LIFESPAN PHYSICIAN GROUP INC
164 SUMMIT AVE
PROVIDENCE, RI 029062853
4017934300
LIFESPAN PHYSICIAN GROUP INC
593 EDDY ST
PROVIDENCE, RI 029034923
Source: CMS National Downloadable File, September 2026.