Provider Demographics
NPI:1548550171
Name:PIECYK, TARAMARIE LILLIAN (RN, NP)
Entity type:Individual
Prefix:
First Name:TARAMARIE
Middle Name:LILLIAN
Last Name:PIECYK
Suffix:
Gender:F
Credentials:RN, NP
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Other - Middle Name:
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Mailing Address - Street 1:1150 RESERVOIR AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6043
Mailing Address - Country:US
Mailing Address - Phone:401-259-0340
Mailing Address - Fax:401-213-8538
Practice Address - Street 1:1150 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6068
Practice Address - Country:US
Practice Address - Phone:401-259-0340
Practice Address - Fax:401-213-8538
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN279166163W00000X, 363LF0000X
RIRN45989363LP0808X, 163W00000X
RINPP37588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RITP91019Medicaid