MEDICARE: TANYA SUTCLIFFE MD

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	207P00000X	Emergency Medicine Physician	64498	TN
2	208000000X	Pediatrics Physician	MD15796	RI
3	208000000X	Pediatrics Physician	LP02163	RI
4	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD15796	RI

General Provider Information

NPI Number	:	1649563859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA SUTCLIFFE MD

Provider Business Mailing Address
First Line	:	PO BOX 9484
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02940-9484
Country	:	US
Telephone Number	:	401-854-2500
Fax Number	:	401-854-2519

Provider Business Practice Location Address
First Line	:	593 EDDY ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-4923
Country	:	US
Telephone Number	:	401-444-4000
Fax Number	:

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

Provider Enumeration Date	:	05/20/2011
Last Update Date	:	12/17/2025

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Directions to “ TANYA SUTCLIFFE MD” Practice Location

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