Healthcare Provider Details

I. General information

NPI: 1790260644
Provider Name (Legal Business Name): BIANCA SIRAVO WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 CENTERVILLE RD STE 101
WARWICK RI
02886-4355
US

IV. Provider business mailing address

469 CENTERVILLE RD STE 101
WARWICK RI
02886-4355
US

V. Phone/Fax

Practice location:
  • Phone: 410-558-7797
  • Fax: 401-446-9094
Mailing address:
  • Phone: 410-558-7797
  • Fax: 401-446-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN04139
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: