ETHAN MOITRA (NPI# 1699046276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699046276 |
| Entity Type | Individual |
| Full Name | ETHAN MOITRA |
| Credential | PH.D. |
| Practice Address |
400 Massasoit Ave Ste 305 Ricbt East Providence RI 02914-2012 |
| Practice Telephone | 4012940451 |
| Practice Fax Number | 4012940461 |
| Mailing Telephone | 4012940451 |
| Mailing Fax Number | 4012940461 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS01274 | RI | Behavioral Health & Social Service Providers |
| Street Address |
400 MASSASOIT AVE STE 305 RICBT |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558407106 | Pamela J Bochiechio | Psychiatry & Neurology | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2007-01-30 |
| 1447877675 | Soyeong Kim | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2020-07-03 |
| 1538717160 | Dorothy Skierkowski-foster | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2019-08-27 |
| 1093296089 | Cara Murphy | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-08-27 |
| 1265923239 | Claire E Blevins | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-05-24 |
| 1780180943 | Hannah Boettcher | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-04-04 |
| 1437577202 | Kara Faye Curry | Psychiatry & Neurology | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2014-03-30 |
| 1144591876 | Patricia A Engler | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2012-01-26 |
| 1245524644 | Meghan K Collier | Clinical Neuropsychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914 | 2011-06-02 |
| 1487887733 | Julie Elizabeth Braciszewski | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2009-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326659012 | Jacob Adrian Lafo | Psychologist | 450 Veterans Memorial Pkwy Ste 8b, East Providence, RI 02914-5315 | 2020-08-14 |
| 1306358239 | Trident Psychological Services | Psychologist | 172 Taunton Ave Ste 208, East Providence, RI 02914-4541 | 2017-11-01 |
| 1548621055 | Heather Schatten | Psychologist | 400 Massasoit Ave # 305, East Providence, RI 02914-2012 | 2016-03-10 |
| 1043591662 | Aaron Kaiser | Psychologist | 400 Massasoit Ave # E305, East Providence, RI 02914-2012 | 2011-09-09 |
| 1538717160 | Dorothy Skierkowski-foster | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2019-08-27 |
| 1578039855 | Nicole Holland Weiss | Psychologist | 400 Massasoit Ave, East Providence, RI 02914-2012 | 2018-10-15 |
| 1093296089 | Cara Murphy | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-08-27 |
| 1265923239 | Claire E Blevins | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-05-24 |
| 1780180943 | Hannah Boettcher | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2018-04-04 |
| 1144591876 | Patricia A Engler | Psychologist | 400 Massasoit Ave Ste 305, East Providence, RI 02914-2012 | 2012-01-26 |
| Find all providers in EAST PROVIDENCE | ||||
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
Please comment or provide details below to improve the information on ETHAN MOITRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.