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NPI Code Detail

MEDICARE: EFRAT EICHENBAUM LP, PHD

MEDICARE:   EFRAT  EICHENBAUM  LP, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistLP5910MN
2103G00000XClinical NeuropsychologistPSY-005404AZ

General Provider Information

NPI Number : 1003265786
Entity Type Code : Individual
Provider Name (Legal Business Name) : EFRAT EICHENBAUM LP, PHD
Provider Business Mailing Address
First Line : 222 W THOMAS RD STE 401
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4423
Country : US
Telephone Number : 602-406-3473
Fax Number : 602-406-4406
Provider Business Practice Location Address
First Line : 222 W THOMAS RD STE 401
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4423
Country : US
Telephone Number : 602-406-3473
Fax Number : 602-406-4406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2016
Last Update Date : 11/12/2021

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Directions to “ EFRAT EICHENBAUM LP, PHD” Practice Location

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