Provider Demographics
NPI:1073644084
Name:ZUROMSKI, EDMOND STANLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDMOND
Middle Name:STANLEY
Last Name:ZUROMSKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:EDMOND
Other - Middle Name:STANLEY
Other - Last Name:ZUROMSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:54 PLAINFIELD PIKE
Mailing Address - Street 2:P.O. BOX 7
Mailing Address - City:FOSTER
Mailing Address - State:RI
Mailing Address - Zip Code:02825-0007
Mailing Address - Country:US
Mailing Address - Phone:401-397-7666
Mailing Address - Fax:
Practice Address - Street 1:54 PLAINFIELD PIKE
Practice Address - Street 2:
Practice Address - City:FOSTER
Practice Address - State:RI
Practice Address - Zip Code:02825-0007
Practice Address - Country:US
Practice Address - Phone:401-397-7666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00509103T00000X, 103TA0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities