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NPI Code Detail

MEDICARE: DR. STEVEN - COLUCCI PH.D.

MEDICARE:  DR. STEVEN - COLUCCI  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
1103TC2200XClinical Child & Adolescent PsychologistPS00429RI

General Provider Information

NPI Number : 1548381247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN - COLUCCI PH.D.
Provider Business Mailing Address
First Line : 215 PINECREST DR
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-5909
Country : US
Telephone Number : 401-294-7274
Fax Number : 401-667-0980
Provider Business Practice Location Address
First Line : 215 PINECREST DR
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-5909
Country : US
Telephone Number : 401-294-7274
Fax Number : 401-667-0980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 07/08/2007

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Directions to “ DR. STEVEN - COLUCCI PH.D.” Practice Location

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