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NPI Code Detail

MEDICARE: DR. ARIEL BOAZ NEIKRUG PH.D.

MEDICARE:  DR. ARIEL BOAZ NEIKRUG  PH.D.
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
1103T00000XPsychologist9482866-2501UT

General Provider Information

NPI Number : 1235504374
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ARIEL BOAZ NEIKRUG PH.D.
Provider Business Mailing Address
First Line : 3381 E SANTA ROSA AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-4281
Country : US
Telephone Number : 760-533-8400
Fax Number :
Provider Business Practice Location Address
First Line : 3381 E SANTA ROSA AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-4281
Country : US
Telephone Number : 760-533-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2015
Last Update Date : 12/01/2015

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Directions to “ DR. ARIEL BOAZ NEIKRUG PH.D.” Practice Location

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