MEDICARE: ROBERT A. BLOCK PHD PC

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
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1760528780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT A. BLOCK PHD PC

Provider Business Mailing Address
First Line	:	17100 N 67TH AVE STE 401
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3698
Country	:	US
Telephone Number	:	602-439-0475
Fax Number	:	516-385-8260

Provider Business Practice Location Address
First Line	:	17100 N 67TH AVE STE 401
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3698
Country	:	US
Telephone Number	:	602-439-0475
Fax Number	:	516-385-8260

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT A BLOCK
Credential	:	PHD
Telephone Number	:	60243909475

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	04/15/2026

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