Healthcare Provider Details

I. General information

NPI: 1780215046
Provider Name (Legal Business Name): ALLISON ARRUDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142A DANIELSON PIKE
FOSTER RI
02825-1485
US

IV. Provider business mailing address

36 BRIDGE WAY
PASCOAG RI
02859-3131
US

V. Phone/Fax

Practice location:
  • Phone: 401-568-7661
  • Fax: 401-568-4771
Mailing address:
  • Phone: 401-568-7661
  • Fax: 401-568-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number39654
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: