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NPI Code Detail

MEDICARE: EDELSON AND ASSOCIATES, INC.

MEDICARE: EDELSON AND ASSOCIATES, INC.
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
1103T00000XPsychologist
2103G00000XClinical Neuropsychologist

General Provider Information

NPI Number : 1952466468
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDELSON AND ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 7511 NEW LAGRANGE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-4859
Country : US
Telephone Number : 502-423-1151
Fax Number : 502-423-1748
Provider Business Practice Location Address
First Line : 7511 NEW LAGRANGE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-4859
Country : US
Telephone Number : 502-423-1151
Fax Number : 502-423-1748
Authorized Official
Title or Position : SECRETARY
Name : STACY CLOYD
Credential :
Telephone Number : 904-605-4986
Provider Enumeration Date : 12/26/2006
Last Update Date : 07/25/2023

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Directions to “EDELSON AND ASSOCIATES, INC. ” Practice Location

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