Neuroperformance Of Rhode Island, Llc | |
2 Regency Plz Ste 3 Providence RI 02903-3149 | |
(401) 383-8198 | |
(401) 437-6959 |
Full Name | Neuroperformance Of Rhode Island, Llc |
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Speciality | Clinical Neuropsychologist |
Location | 2 Regency Plz Ste 3, Providence, Rhode Island |
Authorized Official Name and Position | Melissa Perkins- Banas (NEUROPSYCHOLOGIST) |
Authorized Official Contact | 4013838198 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neuroperformance Of Rhode Island, Llc 2 Regency Plz Ste 3 Providence RI 02903-3149 Ph: (401) 383-8198 | Neuroperformance Of Rhode Island, Llc 2 Regency Plz Ste 3 Providence RI 02903-3149 Ph: (401) 383-8198 |
NPI Number | 1740810548 |
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Provider Enumeration Date | 01/21/2020 |
Last Update Date | 06/11/2020 |
Certification Date | 06/11/2020 |
Medicare PECOS PAC ID | 1456774991 |
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Medicare Enrollment ID | O20200701000171 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740810548 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
Provider Name | Melissa V Perkins-banas |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1932338951 PECOS PAC ID: 1254484207 Enrollment ID: I20180322002503 |
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