Individual
GERALD MARK TARNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1506
Mailing address
1011 VETERANS MEMORIAL PARKWAY, BRADLEY HOSPITAL, EAST PROVIDENCE, RI 02915
(401) 432-1000
(401) 432-1506
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD07782
RI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD07782
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
RI
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
15-58434
UNITED BEHAVIORAL HEALTH
RI
01
—
203937
BLUE CHIP
RI
01
—
25397-2
BLUE CROSS
RI
05
—
7001761
—
RI
Enumeration date
07/31/2006
Last updated
05/07/2015
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