Unknown Individual – Geriatric Psychiatry Physician, NPI 1700817962

Unknown Individual is a healthcare provider. based in Pawtucket, Rhode Island. specializing in Geriatric Psychiatry Physician. They hold a License No. MD09193 (RI). The NPI Number for Unknown Individual is 1700817962

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700817962
Phone
(401) 667-6518
Address
249 ROOSEVELT AVE
Deactivation Date
25 August 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 249, Roosevelt Avenue, Pawtucket, Providence County, Rhode Island, 02860, United States

    SUITE 205

    PAWTUCKET, RI 028602134

    Phone: (401) 667-6518

    Fax: (401) 365-1100

    Type: Mailing

  • Bacon Street, Pawtucket, Providence County, Rhode Island, 02861, United States

    PAWTUCKET, RI 028605542

    Phone: (401) 722-3560

    Fax: (401) 724-3120

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02860)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1700817962.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Geriatric Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Pawtucket, Rhode Island?
For routing, start with Pawtucket, Rhode Island for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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