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General NPI Number Information
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NPI Number | 1447545090
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Entity Type | Organization
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Legal Business Name | RIVKAH M EIDEX PSYD PC
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Dates
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Enumeration Date | 06/12/2011
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 6727 EVANSTON RD
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City | BALTIMORE
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State | MD
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Zip | 21209-3865
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Country | US
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Telephone | 404-321-0250
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Fax | 404-321-3535
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Provider Business Mailing Address
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Address Line | 6727 EVANSTON RD
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City | BALTIMORE
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State | MD
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Zip | 21209-3865
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Country | US
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Telephone | 404-321-0250
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Fax | 404-321-3535
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. RIVKAH M EIDEX
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Credential | PSYD
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Telephone | 404-321-0250
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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 | 2499
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License Number State | GA
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