Individual
BRIAN ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
154 WATERMAN ST, SUITE 16, PROVIDENCE, RI 02906-3116
(401) 500-5638
Mailing address
154 WATERMAN ST, SUITE 16, PROVIDENCE, RI 02906-3116
(401) 500-5638
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD14932
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD14932
RHODE ISLAND MEDICAL LICENSE
RI
Enumeration date
05/13/2015
Last updated
08/06/2015
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