Provider Demographics
NPI:1447828082
Name:GEORGAKAS, JOANNA ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ELIZABETH
Last Name:GEORGAKAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:345 BLACKSTONE BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4829
Mailing Address - Country:US
Mailing Address - Phone:401-455-6375
Mailing Address - Fax:401-455-6535
Practice Address - Street 1:345 BLACKSTONE BLVD BLDG E-160
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6375
Practice Address - Fax:401-455-6545
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RILP052942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry