Healthcare Provider Details

I. General information

NPI: 1457063786
Provider Name (Legal Business Name): JACAYIA JANAI AUSTIN CUARTAS OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DUDLEY ST
PROVIDENCE RI
02905-2401
US

IV. Provider business mailing address

47 WOOD AVE
BARRINGTON RI
02806-3503
US

V. Phone/Fax

Practice location:
  • Phone: 401-533-9100
  • Fax: 401-533-9101
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT02178
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-317227
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: