Provider Demographics
NPI:1730299454
Name:GINSBERG, SUSAN GELFER (PCNS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:GELFER
Last Name:GINSBERG
Suffix:
Gender:F
Credentials:PCNS
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:WALLIS
Other - Last Name:GELFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3240
Mailing Address - Country:US
Mailing Address - Phone:401-245-0042
Mailing Address - Fax:
Practice Address - Street 1:8 BLACKSTONE VALLEY PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1145
Practice Address - Country:US
Practice Address - Phone:401-334-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN25713, PPNS00043364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult