Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD10734 | RI |
N | 111NI0900X | Internist | MD10734 | RI |
Y | 207RA0401X | Internist - Addiction Medicine | MD10734 | RI |
NPI | 1023043056 |
---|---|
Provider Name | Susan H Hart |
First Address | Pawtucket, RI 02860-5123 |
Second Address | Cranston, RI 02910-3225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 28/09/2017 |