Healthcare Provider Details

I. General information

NPI: 1265534366
Provider Name (Legal Business Name): RONALD J. TYSZKOWSKI, DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RICHMOND SQ
PROVIDENCE RI
02906-5100
US

IV. Provider business mailing address

PO BOX 9117
WARWICK RI
02889-0117
US

V. Phone/Fax

Practice location:
  • Phone: 401-751-6568
  • Fax: 401-490-3976
Mailing address:
  • Phone: 401-751-6568
  • Fax: 401-490-3976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number346
License Number StateRI

VIII. Authorized Official

Name: DR. RONALD J TYSZKOWSKI
Title or Position: DOCTOR OWNER
Credential: D.C.
Phone: 401-751-6568