| Elizabeth Pangrazzi | |
|
1102 Carpenter Ave Iron Mountain MI 49801-4722 | |
| (906) 202-9444 | |
| (906) 828-1603 |
| Full Name | Elizabeth Pangrazzi |
|---|---|
| Speciality | Psychologist |
| Location | 1102 Carpenter Ave, Iron Mountain, Michigan |
| Authorized Official Name and Position | Elizabeth Pangrazzi (OWNER) |
| Authorized Official Contact | 9062029444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Pangrazzi 1102 Carpenter Ave Iron Mountain MI 49801-4722 Ph: (906) 202-9444 | Elizabeth Pangrazzi 1102 Carpenter Ave Iron Mountain MI 49801-4722 Ph: (906) 202-9444 |
| NPI Number | 1780226480 |
|---|---|
| Provider Enumeration Date | 10/14/2019 |
| Last Update Date | 04/21/2020 |
| Certification Date | 04/21/2020 |
| Medicare PECOS PAC ID | 5698196855 |
|---|---|
| Medicare Enrollment ID | O20200513001922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780226480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Pangrazzi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003026824 PECOS PAC ID: 2961687736 Enrollment ID: I20191116000443 |
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