Healthcare Provider Details

I. General information

NPI: 1760308878
Provider Name (Legal Business Name): TASHA MARIETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DYER ST
PROVIDENCE RI
02903-3927
US

IV. Provider business mailing address

767 EAST AVE
HARRISVILLE RI
02830-1517
US

V. Phone/Fax

Practice location:
  • Phone: 401-203-3779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberRN35155
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: