Provider Demographics
NPI:1821256140
Name:INTEGRATED PSYCHIATRY INCORPORATED
Entity Type:Organization
Organization Name:INTEGRATED PSYCHIATRY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-277-9992
Mailing Address - Street 1:75 NEWMAN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1945
Mailing Address - Country:US
Mailing Address - Phone:401-453-0666
Mailing Address - Fax:
Practice Address - Street 1:663 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5322
Practice Address - Country:US
Practice Address - Phone:401-277-9992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI92162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty