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Individual

EDYTA REIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
101-103 BACON STREET, PAWTUCKET, RI 02860
(401) 722-3560
(401) 722-5280
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN54971
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1821078932
GATEWAY
Enumeration date
06/22/2018
Last updated
08/13/2019
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