Active NPI
Matt Zaitchik, PH.D.
- Forensic Psychologist
- North Providence, RI
National Provider Identifier
1639669237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 4714-PY-PR
- Practice address
- 102C Palmer Dr
North Providence, RI 02904-7741 - Phone
- (401) 254-5333
- NPI assigned
- May 18, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 4714-PY-PR | MA | Primary |
Addresses
Primary practice location
102C Palmer Dr
North Providence, RI 02904-7741
Mailing address
102C Palmer Dr
North Providence, RI 02904-7741
Phone (401) 254-5333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4714-PY-PR | MA | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1639669237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102C PALMER DR",
"city": "NORTH PROVIDENCE",
"state": "RI",
"postal_code": "029047741",
"telephone_number": "401-254-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102C PALMER DR",
"city": "NORTH PROVIDENCE",
"state": "RI",
"postal_code": "029047741",
"telephone_number": "401-254-5333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAITCHIK",
"first_name": "MATT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-18",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Forensic",
"state": "MA",
"license": "4714-PY-PR",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.