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NPI Code Detail

MEDICARE: CORTEX CARE NEUROPSYCHOLOGY PLLC

MEDICARE: CORTEX CARE NEUROPSYCHOLOGY PLLC
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 Neuropsychologist

General Provider Information

NPI Number : 1841016391
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORTEX CARE NEUROPSYCHOLOGY PLLC
Provider Business Mailing Address
First Line : PO BOX 93092
Second Line :
City : PHOENIX
State : AZ
Zip : 85070-3092
Country : US
Telephone Number : 903-570-3069
Fax Number :
Provider Business Practice Location Address
First Line : 4435 E CHANDLER BLVD
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-7649
Country : US
Telephone Number : 602-551-6044
Fax Number : 480-542-2204
Authorized Official
Title or Position : MEMBER/MANAGER
Name : PELIN STREBLER
Credential : PHD
Telephone Number : 602-551-6044
Provider Enumeration Date : 12/02/2024
Last Update Date : 12/16/2024

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