Healthcare Provider Details

I. General information

NPI: 1154840254
Provider Name (Legal Business Name): ADRIENNE PIETRASZKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 SERVICE AVE FL 1
WARWICK RI
02886-1014
US

IV. Provider business mailing address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-430-2000
  • Fax: 401-453-7597
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW02015
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: