Provider Demographics
NPI:1992869531
Name:NERO, DAWN KATHLEEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:KATHLEEN
Last Name:NERO
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 1:1086 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908
Mailing Address - Country:US
Mailing Address - Phone:401-585-0091
Mailing Address - Fax:401-369-9275
Practice Address - Street 1:1086 SMITH ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-369-9224
Practice Address - Fax:401-369-9275
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014057103TC0700X
RIPS1213103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV823P1Medicare UPIN