Provider Demographics
NPI:1679568802
Name:EJNES, YUL (MD)
Entity Type:Individual
Prefix:DR
First Name:YUL
Middle Name:
Last Name:EJNES
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 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:75 SOCKANOSSET CROSS RD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5558
Practice Address - Country:US
Practice Address - Phone:401-946-6200
Practice Address - Fax:401-275-1992
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07587207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI04-00467OtherUNITED HEALTH CARE
RI400805OtherBLUE CHIP
RI10111679OtherRAILROAD MEDICARE
RI60314OtherHARVARD HEALTH PLAN
RI709003712OtherMEDICARE GROUP
RI710065701OtherCIGNA
RI7001857Medicaid
RI404470OtherTUFTS HEALTH PLAN
RI20251-4OtherBCBS OF RI
RI050483739OtherGREAT WEST HEALTH CARE
RI4089OtherNEIGHBORHOOD HEALTH PLAN
RI7001857Medicaid
RI710065701OtherCIGNA
RI10111679OtherRAILROAD MEDICARE