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NPI Code Detail

MEDICARE: TIMOTHY RICHARD CEFAI FLP

MEDICARE: TIMOTHY RICHARD CEFAI FLP
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
1103T00000XPsychologist6301008331MI

General Provider Information

NPI Number : 1487618070
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY RICHARD CEFAI FLP
Provider Business Mailing Address
First Line : 4129 OKEMOS RD
Second Line : SUITE 6
City : OKEMOS
State : MI
Zip : 48864-2822
Country : US
Telephone Number : 517-333-4858
Fax Number : 517-999-3187
Provider Business Practice Location Address
First Line : 812 E JOLLY RD
Second Line : SUITE 111
City : LANSING
State : MI
Zip : 48910-6818
Country : US
Telephone Number : 517-346-8200
Fax Number : 517-346-8291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 07/08/2007

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Directions to “ TIMOTHY RICHARD CEFAI FLP” Practice Location

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