Healthcare Provider Details

I. General information

NPI: 1891412078
Provider Name (Legal Business Name): JOY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ELMWOOD AVE
PROVIDENCE RI
02907-1701
US

IV. Provider business mailing address

520 ELMWOOD AVE
PROVIDENCE RI
02907-1701
US

V. Phone/Fax

Practice location:
  • Phone: 401-386-4343
  • Fax: 401-386-4355
Mailing address:
  • Phone: 401-386-4343
  • Fax: 401-386-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MAYELIN PACHECO NUNEZ
Title or Position: CLINIC DIRECTOR
Credential: APRN
Phone: 508-863-6202