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NPI Code Detail

MEDICARE: ELLIOT FIELSTEIN PHD

MEDICARE: ELLIOT FIELSTEIN 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
1103G00000XClinical NeuropsychologistP2082TN

General Provider Information

NPI Number : 1356440788
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIOT FIELSTEIN PHD
Provider Business Mailing Address
First Line : 2203 WESTVIEW DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-4123
Country : US
Telephone Number : 615-385-4635
Fax Number :
Provider Business Practice Location Address
First Line : 2203 WESTVIEW DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-4123
Country : US
Telephone Number : 615-385-4635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 08/10/2011

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