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Individual

OMER CERMIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
(401) 861-8696
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD10213
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007059462
MEDICARE ID-TYPE UNSPECIFIED
RI
01
15-26435
UBH
RI
01
22129-8
BLUE CROSS
RI
01
406989
BLUE CHIP
RI
05
7007566
RI
Enumeration date
08/01/2006
Last updated
03/12/2025
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