Provider Demographics
NPI:1548350861
Name:OPPENHEIMER, PETER M (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:OPPENHEIMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 WASECA AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3522
Mailing Address - Country:US
Mailing Address - Phone:401-245-0015
Mailing Address - Fax:
Practice Address - Street 1:260 WASECA AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3522
Practice Address - Country:US
Practice Address - Phone:401-245-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI353103TC0700X
MA4412103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical