NPI 1790722627 · live from the CMS NPI Registry
John R Boekamp, PHD
Psychologist, Clinical in East Providence, RI. National Provider Identifier 1790722627, active.
NPI record
| NPI | 1790722627 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 1011 Veterans Memorial Pkwy, East Providence, RI 02915 |
| Practice phone | 401-432-1417 |
| Enumerated | May 31, 2006 |
| Last updated | January 6, 2011 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | PS00666 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.