Bologna-Jill, Traci M

Bologna-Jill, Traci M is an individual health care provider with primary practice located at 1 Randall Sq Ste 408 , Providence RI 02904-7405. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Bologna-Jill, Traci M can be contacted via phone (401) 453-2000.

Contact Information

Primary practice address
1 Randall Sq Ste 408 Providence RI 02904-7405
Phone: (401) 453-2000
Fax: (401) 253-2002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X DPM00367 Rhode Island

Profile Details

NPI number 1346746062
LBN Legal business name Bologna-Jill, Traci M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2018
Last updated Dec 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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