| Dmitry Meyerson, Ph. D., Llc | |
|
177 Airport Rd Warwick RI 02889-1046 | |
| (401) 329-2210 | |
| (401) 340-1052 |
| Full Name | Dmitry Meyerson, Ph. D., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 177 Airport Rd, Warwick, Rhode Island |
| Authorized Official Name and Position | Dmitry Meyerson (CEO/OWNER) |
| Authorized Official Contact | 4013292210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmitry Meyerson, Ph. D., Llc 177 Airport Rd Warwick RI 02889-1046 Ph: (401) 329-2210 | Dmitry Meyerson, Ph. D., Llc 177 Airport Rd Warwick RI 02889-1046 Ph: (401) 329-2210 |
| NPI Number | 1639836117 |
|---|---|
| Provider Enumeration Date | 11/19/2021 |
| Last Update Date | 11/19/2021 |
| Certification Date | 10/27/2021 |
| Medicare PECOS PAC ID | 1658761689 |
|---|---|
| Medicare Enrollment ID | O20211207001642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639836117 | NPI | - | NPPES |
| RI-1972033827 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dmitry Meyerson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972033827 PECOS PAC ID: 4082980586 Enrollment ID: I20171030000142 |
| Provider Name | Christine Sanford Forsyth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225445083 PECOS PAC ID: 0840681383 Enrollment ID: I20211217000190 |
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