Provider Demographics
NPI:1942307657
Name:PLUMMER, BARRY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:A
Last Name:PLUMMER
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 1:2 REGENCY PLZ
Mailing Address - Street 2:SUITE-4
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-3160
Mailing Address - Country:US
Mailing Address - Phone:401-351-0236
Mailing Address - Fax:401-351-5005
Practice Address - Street 1:2 REGENCY PLZ
Practice Address - Street 2:SUITE 4
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3160
Practice Address - Country:US
Practice Address - Phone:401-351-0236
Practice Address - Fax:401-351-5005
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS000245103TC0700X
MA3113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical