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Individual

TANYA JEAN BECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
126 PROSPECT ST, PAWTUCKET, RI 02860-4429
(401) 728-9206
(401) 722-6960
Mailing address
59 PROSPECT ST, SUITE C, PAWTUCKET, RI 02860-4482
(401) 728-9206
(401) 722-6960

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD10708
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TB55273
RI
Enumeration date
08/19/2005
Last updated
07/15/2013
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