Individual
TARESA KULIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
593 EDDY ST, SUITE 443, PROVIDENCE, RI 02903-4923
(401) 453-9625
(401) 435-7069
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00012
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942282
—
RI
Enumeration date
11/16/2005
Last updated
01/29/2020
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