Active NPI
Susan Czernicka, EDD
- Psychologist
- New Bedford, MA
National Provider Identifier
1881684579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2731
- Practice address
- 345 Union St
New Bedford, MA 02740-3679 - Phone
- (617) 835-8175
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2731 | MA | Primary |
Addresses
Primary practice location
345 Union St
New Bedford, MA 02740-3679
Mailing address
800 Purchase St
Suite 306
New Bedford, MA 02740-6355
Phone (617) 835-8175
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2731 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1881684579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 PURCHASE ST",
"address_2": "SUITE 306",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027406355",
"telephone_number": "617-835-8175",
"fax_number": "508-300-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 UNION ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027403679",
"telephone_number": "617-835-8175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZERNICKA",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-25",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "2731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.