Individual
DR. MICHAEL GERSHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
889 CENTERVILLE RD, WARWICK, RI 02886-4342
(401) 821-4100
(401) 823-9180
Mailing address
99 CUMBERLAND RD, WARWICK, RI 02886-8709
(401) 885-4088
(401) 823-9180
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00171
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000030545
RI BLUE CROSS PROVIDER #
RI
01
—
000873
RI BLUE CHIP PROVIDER #
RI
01
—
6108438
UNITED HAELTH PROVIDER #
RI
05
—
MG51041
—
RI
Enumeration date
03/22/2007
Last updated
07/09/2007
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