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General NPI Number Information
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NPI Number | 1922213628
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Entity Type | Organization
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Legal Business Name | DR. GERALD P. ELOVITZ, P.C.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 1860 SANTUIT-NEWTOWN RD
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City | COTUIT
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State | MA
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Zip | 02635-2509
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Country | US
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Telephone | 508-420-9989
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Fax |
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Provider Business Mailing Address
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Address Line | 1860 SANTUIT-NEWTOWN RD
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City | COTUIT
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State | MA
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Zip | 02635-2509
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Country | US
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Telephone | 508-420-9989
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Fax |
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | DR. GERALD PAUL ELOVITZ
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Credential | D.ED.
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Telephone | 508-420-9989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 2591
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License Number State | MA
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