MEDICARE: DR. FRANCIS R SPARADEO PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist	PS00241	RI
2	103TC0700X	Clinical Psychologist	PS00241	RI
3	103G00000X	Clinical Neuropsychologist	PS00241	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1022270	OTHER	RI	NEIGHBORHOOD HEALTH PLAN
2	9239-5	OTHER	RI	BLUE CROSS
3	400090	OTHER	RI	BLUE CHIP

General Provider Information

NPI Number	:	1134252794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS R SPARADEO PH.D.

Provider Business Mailing Address
First Line	:	1130 TEN ROD RD STE E201
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4168
Country	:	US
Telephone Number	:	401-398-7681
Fax Number	:	401-615-9908

Provider Business Practice Location Address
First Line	:	1130 TEN ROD RD STE E201
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4168
Country	:	US
Telephone Number	:	401-398-7681
Fax Number	:	401-615-9908

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	05/16/2024

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