| Alexander Kushch, Phd, Pa | |
|
5353 N Federal Hwy Suite 208 Fort Lauderdale FL 33308-3245 | |
| (954) 296-1048 | |
| (954) 533-1937 |
| Full Name | Alexander Kushch, Phd, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 5353 N Federal Hwy, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Alexander Kushch (PRESIDENT) |
| Authorized Official Contact | 9542961048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Kushch, Phd, Pa 8930 W State Road 84 No. 113 Davie FL 33324-4456 Ph: (954) 296-1048 | Alexander Kushch, Phd, Pa 5353 N Federal Hwy Suite 208 Fort Lauderdale FL 33308-3245 Ph: (954) 296-1048 |
| NPI Number | 1700158078 |
|---|---|
| Provider Enumeration Date | 02/02/2012 |
| Last Update Date | 02/02/2012 |
| Medicare PECOS PAC ID | 5193980910 |
|---|---|
| Medicare Enrollment ID | O20120629000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700158078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5881 (Florida) | Primary |
| Provider Name | Alexander Kushch |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1871676262 PECOS PAC ID: 7214997725 Enrollment ID: I20041018001172 |
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