Provider Demographics
NPI:1922210731
Name:ANN PORTO PSYD & ASSOCIATES INC
Entity Type:Organization
Organization Name:ANN PORTO PSYD & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:401-351-0400
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:401-453-9619
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-351-0400
Practice Address - Fax:401-351-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty