MEDICARE: MELISSA QUIGLEY OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT290	RI

General Provider Information

NPI Number	:	1437759776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA QUIGLEY OTR

Provider Business Mailing Address
First Line	:	28 CORNELL AVE
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02888-4414
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 N QUIDNESSETT RD
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-1000
Country	:	US
Telephone Number	:	401-884-1802
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/27/2020

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