Provider Demographics
NPI:1417961483
Name:COMISKEY, THOMAS JOSEPH (PHD PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:COMISKEY
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 GIBSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882
Mailing Address - Country:US
Mailing Address - Phone:401-783-1798
Mailing Address - Fax:401-789-3748
Practice Address - Street 1:24 SALT POND RD
Practice Address - Street 2:SUITE D4
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-789-3694
Practice Address - Fax:401-789-3748
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI188103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI411737OtherBC
RITC04109Medicaid
RI411737OtherBLUE CHIP