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Physician Compare National (NPI:1013205277)

HEALTHCARE PROVIDER: MARA LENOX BRONSTEIN PSY.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1013205277
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4486965878
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20150626000351
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BRONSTEIN
Individual professional last name
Provider First Name MARA
Individual professional first name
Provider Middle Name LENOX
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2009
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 881 FREMONT AVE
Group Practice or individual's line 1 address
Line 2 Street Address B8
Group Practice or individual's line 2 address
City LOS ALTOS
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 940245637
Group Practice or individual's zip code (9 digits when available)
Phone Number 6502314835
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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