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Individual

MARY E BORATYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
186 PROVIDENCE ST, THUNDERMIST HEALTH CENTER, WEST WARWICK, RI 02893-2508
(401) 615-2800
(401) 615-2805
Mailing address
285 GOVERNOR ST STE 3, PROVIDENCE, RI 02906-3237
(401) 383-4411
(401) 383-8010

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
NPP37490
RI
363LP0200X
Pediatric Nurse Practitioner
Primary
NPP37490
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MA73809
RI
Enumeration date
11/11/2008
Last updated
01/16/2020
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