Ms Tinatin Surguladze, DHD is a
Psychologist based in Providence, Rhode Island. Ms Tinatin Surguladze is licensed to practice in Rhode Island (license number PS01795) and her current practice location is
205 Waterman St Suite 106, Providence, Rhode Island. She can be reached at her office (for appointments etc.) via phone at
(857) 333-0533.
NPI number for Ms Tinatin Surguladze is 1700289360 and her current mailing address is 3 Burgess Rd, Foster, Rhode Island. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1700289360.
Healthcare Provider's Profile
| Full Name | Ms Tinatin Surguladze |
|---|
| Gender | Female |
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| Speciality | Psychologist |
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| Location | 205 Waterman St Suite 106, Providence, Rhode Island |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1700289360
- Provider Enumeration Date: 09/26/2014
- Last Update Date: 04/29/2020
Medical Identifiers
Medical identifiers for Ms Tinatin Surguladze such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1700289360 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 11259 (Massachusetts) | Secondary |
| 103T00000X | Psychologist | PS01795 (Rhode Island) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Tinatin Surguladze is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Tinatin Surguladze, DHD
3 Burgess Rd,
Foster, RI 02825
Ph: (857) 333-0533 | Ms Tinatin Surguladze, DHD
205 Waterman St Suite 106,
Providence, RI 02906
Ph: (857) 333-0533 |
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