Moon, Sydney Sumi

Moon, Sydney Sumi is an individual health care provider with primary practice located at 593 Eddy St Lifespan Physcian Group, Providence RI 02903-4923. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychosomatic Medicine, which is considered as her primary health care specialty. Moon, Sydney Sumi can be contacted via phone (401) 444-2128.

Contact Information

Primary practice address
593 Eddy St Lifespan Physcian Group Providence RI 02903-4923
Phone: (401) 444-2128
Fax: (401) 444-8836
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X 14228 Rhode Island

Profile Details

NPI number 1114954583
LBN Legal business name Moon, Sydney Sumi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Mar 31st, 2017 - about 9 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 1114954583 NPPES
Massachusetts MEDICAID 110073955A

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