Provider Demographics
NPI:1972675791
Name:GORRIARAN-GOODWIN, TANYA TERESA (MSPT)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:TERESA
Last Name:GORRIARAN-GOODWIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3445 POST ROAD
Mailing Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER ATTN KIM RUELLE HR
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7147
Mailing Address - Country:US
Mailing Address - Phone:401-739-2700
Mailing Address - Fax:401-737-8907
Practice Address - Street 1:3445 POST ROAD
Practice Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER ATTN KIM RUELLE HR
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7147
Practice Address - Country:US
Practice Address - Phone:401-739-2700
Practice Address - Fax:401-737-8907
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI232931OtherBCBS
RI408272OtherBLUE CHIP
RIKC02260Medicaid
RI6400187OtherUNITED HEALTHCARE
RI4224OtherNEIGHBORHOOD HEALTH
RI0117OtherNEIGHBORHOOD HEALTH