Peter J Gillen, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS00823 Issued in RI

Practice address

1011 Veterans Memorial Pkwy
East Providence, RI 02915-5061

Phone

(402) 432-1533

Fax

(401) 432-1500

NPI assigned

Jun 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1992743371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "402-432-1284",
            "fax_number": "401-432-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "402-432-1533",
            "fax_number": "401-432-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEN",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG70349",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "9613312",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane R Gerzevitz, NPP
• Michele B Gessman, MSW
• Vincenzo Gianfrancesco
• Gil Teixeira DO Inc
• Joseph Gil, M.D.
• Michael F Gilson, MD
• Lawrence T Ginsberg, O.D.
• Tatiana Giraldo, OD
• Douglas J Glod, DPM
• Ryan Joseph Glode, M.A., LMHC

• Clinical Psychologist in East Providence, RI
• Providers in East Providence, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.