Provider Demographics
NPI:1487643565
Name:JOSEPH-DELVECCHIO, JANE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:MARIA
Last Name:JOSEPH-DELVECCHIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:MARIA
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:168 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3828
Mailing Address - Country:US
Mailing Address - Phone:401-886-6700
Mailing Address - Fax:
Practice Address - Street 1:168 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3828
Practice Address - Country:US
Practice Address - Phone:401-886-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9021357Medicaid
RIG57175Medicare UPIN
RI189021357Medicare ID - Type Unspecified