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General NPI Number Information
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NPI Number | 1467719088
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Entity Type | Individual
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Provider Name | LILY PIKE MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 45 ROYAL LITTLE DR
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City | PROVIDENCE
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State | RI
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Zip | 02904-1882
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Country | US
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Telephone | 401-808-6693
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Fax | 401-654-5319
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Provider Business Mailing Address
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Address Line | 1052 PARK AVE
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City | CRANSTON
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State | RI
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Zip | 02910-3225
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Country | US
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Telephone | 401-461-5056
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Fax | 401-942-3590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD15934
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD15934
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License Number State | RI
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