Healthcare Provider Details

I. General information

NPI: 1235049073
Provider Name (Legal Business Name): JOY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
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 Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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