Individual
MARY SECCARECCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8982
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8982
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
RI12101
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI12101
LICENSE
RI
Enumeration date
05/08/2007
Last updated
07/08/2007
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