| George Medzerian Ph.d. Inc. | |
|
428 Sw 7th St Stuart FL 34994-2908 | |
| (772) 283-0013 | |
| (772) 219-4785 |
| Full Name | George Medzerian Ph.d. Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 428 Sw 7th St, Stuart, Florida |
| Authorized Official Name and Position | George Medzerian (PSYCHOLOGIST) |
| Authorized Official Contact | 7724850235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George Medzerian Ph.d. Inc. 428 Sw 7th St Stuart FL 34994-2908 Ph: (772) 283-0013 | George Medzerian Ph.d. Inc. 428 Sw 7th St Stuart FL 34994-2908 Ph: (772) 283-0013 |
| NPI Number | 1568763944 |
|---|---|
| Provider Enumeration Date | 11/16/2010 |
| Last Update Date | 11/16/2010 |
| Medicare PECOS PAC ID | 2264621200 |
|---|---|
| Medicare Enrollment ID | O20110106000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568763944 | NPI | - | NPPES |
| FL2095 | Other | FL | BRADMAN |
| 089002 | Other | VALUE OPTIONS | |
| 5371572 | Other | AETNA | |
| 75859 | Other | BLUE CROSS BLUE SHIELD | |
| 215000 | Other | PHCS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY3086 (Florida) | Primary |
| Provider Name | George J Medzerian |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1134284920 PECOS PAC ID: 8921999194 Enrollment ID: I20040324001520 |
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