Provider Demographics
NPI:1508822057
Name:ZARTLER, ANN S (PH D)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:ZARTLER
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 JUNIPER CIR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02835-2919
Mailing Address - Country:US
Mailing Address - Phone:401-423-0407
Mailing Address - Fax:
Practice Address - Street 1:30 JUNIPER CIR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02835-2919
Practice Address - Country:US
Practice Address - Phone:401-596-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI269003905Medicare ID - Type UnspecifiedPROVIDER NUMBER