Healthcare Provider Details

I. General information

NPI: 1427606813
Provider Name (Legal Business Name): NEW ENGLAND CENTER FOR PEDIATRIC PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 WORCESTER AVE
RIVERSIDE RI
02915-3409
US

IV. Provider business mailing address

109 WORCESTER AVE
RIVERSIDE RI
02915-3409
US

V. Phone/Fax

Practice location:
  • Phone: 401-369-3259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT PRESSMAN
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 401-369-3259