| Susan Czernicka Pc | |
|
800 Purchase St Suite 306 New Bedford MA 02740-6355 | |
| (617) 835-8175 | |
| (508) 300-0206 |
| Full Name | Susan Czernicka Pc |
|---|---|
| Speciality | Psychologist |
| Location | 800 Purchase St, New Bedford, Massachusetts |
| Authorized Official Name and Position | Susan Czernicka (PSYCHOLOGIST) |
| Authorized Official Contact | 6178358175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Czernicka Pc 1414 Drift Rd Westport MA 02790-1629 Ph: (617) 835-8175 | Susan Czernicka Pc 800 Purchase St Suite 306 New Bedford MA 02740-6355 Ph: (617) 835-8175 |
| NPI Number | 1649485590 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 11/21/2008 |
| Medicare PECOS PAC ID | 4284790809 |
|---|---|
| Medicare Enrollment ID | O20090306000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649485590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2731 (Massachusetts) | Primary |
| Provider Name | Susan Czernicka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881684579 PECOS PAC ID: 5092817858 Enrollment ID: I20070226000036 |
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