MEDICARE: EMILY RUSSELL ASKIN PHD

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	103G00000X	Clinical Neuropsychologist	TPS029939	PA
2	103T00000X	Psychologist	TPS029939	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942238795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY RUSSELL ASKIN PHD

Provider Business Mailing Address
First Line	:	1518 WALNUT ST
Second Line	:	SUITE 1103
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3419
Country	:	US
Telephone Number	:	202-253-9570
Fax Number	:	215-985-0220

Provider Business Practice Location Address
First Line	:	1518 WALNUT ST
Second Line	:	SUITE 1103
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3419
Country	:	US
Telephone Number	:	215-587-3122
Fax Number	:	215-985-0220

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/06/2020

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