Gershon, Jonathan

Gershon, Jonathan is an individual health care provider with primary practice located at 889 Centerville Rd , Warwick RI 02886-4342. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gershon, Jonathan can be contacted via phone (401) 821-4100.

Contact Information

Primary practice address
889 Centerville Rd Warwick RI 02886-4342
Phone: (401) 821-4100
Fax: (401) 823-9180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS00833 Rhode Island

Profile Details

NPI number 1962528406
LBN Legal business name Gershon, Jonathan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Feb 2nd, 2011 - about 14 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 1962528406 NPPES
Rhode Island Other 0000027348 RI BLUE CROSS PROVIDER #
Rhode Island MEDICAID JG54521 RI BLUE CROSS PROVIDER #
Rhode Island Other 411605 RI BLUE CROSS PROVIDER #

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