Provider Demographics
NPI:1386604890
Name:BRONSKY, SHARI G (PSYD)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:G
Last Name:BRONSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SCRABBLETOWN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3638
Mailing Address - Country:US
Mailing Address - Phone:401-268-5333
Mailing Address - Fax:855-268-5333
Practice Address - Street 1:1170 PONTIAC AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-7944
Practice Address - Country:US
Practice Address - Phone:401-500-0424
Practice Address - Fax:401-296-3998
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00984103TC0700X
MA7436103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical