MEDICARE: DR. RICHARD DANIEL SUTTER 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	103T00000X	Psychologist	8310	NY

General Provider Information

NPI Number	:	1821384629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DANIEL SUTTER PH.D.

Provider Business Mailing Address
First Line	:	975 E WINDSOR RD
Second Line	:
City	:	WINDSOR
State	:	MA
Zip	:	01270-9607
Country	:	US
Telephone Number	:	413-347-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 E WINDSOR RD
Second Line	:
City	:	WINDSOR
State	:	MA
Zip	:	01270-9607
Country	:	US
Telephone Number	:	413-347-0366
Fax Number	:

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

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	04/10/2014

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