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Individual

ANDREW MARC TAREILA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5127
(401) 444-3056
Mailing address
125 METRO CENTER BLVD, WARWICK, RI 02886-1768
(401) 432-2500
(401) 921-9212

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD17185
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LP04344
LICENSE NUMBER
RI
Enumeration date
06/06/2018
Last updated
03/01/2023
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