Individual
SUSAN PITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
75 SOCKANOSSET CROSS RD, CRANSTON, RI 02920-5558
(401) 946-6200
(401) 275-1992
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00050
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21026
BCBS OF RI
RI
01
—
406468
BLUE CHIP
RI
01
—
709003712
MEDICARE GROUP
RI
05
—
9021026
—
RI
Enumeration date
09/14/2005
Last updated
07/16/2012
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