Healthcare Provider Details

I. General information

NPI: 1760851497
Provider Name (Legal Business Name): ALLISON BROWNE PIASCIK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

15 NIPSAH RD
EAST GREENWICH RI
02818-4615
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-5435
  • Fax:
Mailing address:
  • Phone: 401-300-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00838
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: