Dickstein, Susan

Dickstein, Susan is an individual health care provider with primary practice located at 1011 Veterans Memorial Pkwy , East Providence RI 02915-5061. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dickstein, Susan can be contacted via phone (401) 793-8731.

Contact Information

Primary practice address
1011 Veterans Memorial Pkwy East Providence RI 02915-5061
Phone: (401) 793-8731
Fax: (401) 432-1500
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS00463 Rhode Island

Profile Details

NPI number 1104869635
LBN Legal business name Dickstein, Susan
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104869635 NPPES
Rhode Island Other 406326 BLUE CHIP
Rhode Island Other 61-15830 BLUE CHIP
Rhode Island Other 30175-2 BLUE CHIP
Rhode Island MEDICAID SD10788 BLUE CHIP

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