Provider Demographics
NPI:1619975067
Name:FINGERUT, JERALD CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JERALD
Middle Name:CHARLES
Last Name:FINGERUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 TAUGWONK RD
Mailing Address - Street 2:
Mailing Address - City:STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06378-1805
Mailing Address - Country:US
Mailing Address - Phone:860-535-3067
Mailing Address - Fax:
Practice Address - Street 1:42 PARK PL
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4010
Practice Address - Country:US
Practice Address - Phone:401-729-0080
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine