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General NPI Number Information
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NPI Number | 1144350273
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Entity Type | Organization
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Legal Business Name | IRL L EXTEIN MD PA
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16244 MILITARY TRL 325
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6534
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Country | US
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Telephone | 561-499-6716
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Fax |
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Provider Business Mailing Address
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Address Line | 16244 MILITARY TRL 325
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6534
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Country | US
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Telephone | 561-499-6716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRL L EXTEIN
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Credential | M.D.
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Telephone | 561-499-6716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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