MEDICARE: DR. PEARL K. ZURICH PSYD

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
1	103TC0700X	Clinical Psychologist	0810005387	VA

General Provider Information

NPI Number	:	1730540204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEARL K. ZURICH PSYD

Provider Business Mailing Address
First Line	:	1485 CHAIN BRIDGE RD
Second Line	:	SUITE 202
City	:	MC LEAN
State	:	VA
Zip	:	22101-4501
Country	:	US
Telephone Number	:	703-400-0654
Fax Number	:

Provider Business Practice Location Address
First Line	:	1485 CHAIN BRIDGE RD
Second Line	:	SUITE 202
City	:	MC LEAN
State	:	VA
Zip	:	22101-4501
Country	:	US
Telephone Number	:	703-400-0654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	03/11/2016

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