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NPI Code Detail

MEDICARE: RONALD M WESTRATE PH.D.

MEDICARE: RONALD M WESTRATE PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0700XAdult Development & Aging Psychologist35SI00157600NJ
2103TB0200XCognitive & Behavioral Psychologist20042356AIN

General Provider Information

NPI Number : 1083644546
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD M WESTRATE PH.D.
Provider Business Mailing Address
First Line : 4860 ROBB ST 201
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-2162
Country : US
Telephone Number : 303-278-7418
Fax Number :
Provider Business Practice Location Address
First Line : 1380E COUNTY LINE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-0962
Country : US
Telephone Number : 317-885-7050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 08/18/2015

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