Healthcare Provider Details

I. General information

NPI: 1811360795
Provider Name (Legal Business Name): ARIST MEDICAL SCIENCES UNIVERSITY, PBC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 CALLE DR LUIS F SALAS URB IND REPARADA 2
PONCE PR
00716
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-2525
  • Fax: 787-840-5231
Mailing address:
  • Phone: 787-840-2575
  • Fax: 787-840-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID LENIHAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 787-840-2575