Provider Demographics
NPI:1487689089
Name:TODARO, JOHN F (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:TODARO
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 1:1086 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2738
Mailing Address - Country:US
Mailing Address - Phone:401-369-9224
Mailing Address - Fax:401-369-9275
Practice Address - Street 1:1086 SMITH STREET
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:20908-2738
Practice Address - Country:US
Practice Address - Phone:401-277-0658
Practice Address - Fax:866-448-1380
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00948103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical