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General NPI Number Information
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NPI Number | 1053744201
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Entity Type | Organization
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Legal Business Name | AAA NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 101 LINDENWOOD DR SUITE 225
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City | MALVERN
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State | PA
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Zip | 19355-1755
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Country | US
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Telephone | 484-870-5608
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Fax |
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Provider Business Mailing Address
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Address Line | 101 LINDENWOOD DR SUITE 225
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City | MALVERN
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State | PA
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Zip | 19355-1755
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Country | US
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Telephone | 484-870-5608
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | FARZIN IRANI
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Credential | PH.D.
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Telephone | 484-870-5608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS017067
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License Number State | PA
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