=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144297698
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN ANN SCLAMA PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2006
-----------------------------------------------------
Last Update Date | 11/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 640 GEORGE WASHINGTON HWY BLDG A, SUITE 102
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-921-7900
-----------------------------------------------------
Fax | 401-921-6959
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 455 TOLL GATE RD PRC AND CREDENTIALING
-----------------------------------------------------
City | WARWICK
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02886-2759
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-273-0641
-----------------------------------------------------
Fax | 401-273-2919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA00220
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------