| Ira Potashner, Psyd | |
|
61 S Main St Ste 209 West Hartford CT 06107-2403 | |
| (646) 575-5848 | |
| Not Available |
| Full Name | Ira Potashner, Psyd |
|---|---|
| Speciality | Psychologist |
| Location | 61 S Main St Ste 209, West Hartford, Connecticut |
| Authorized Official Name and Position | Ira Potashner (OWNER) |
| Authorized Official Contact | 6465755848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ira Potashner, Psyd 61 S Main St Ste 209 West Hartford CT 06107-2403 Ph: (646) 575-5848 | Ira Potashner, Psyd 61 S Main St Ste 209 West Hartford CT 06107-2403 Ph: (646) 575-5848 |
| NPI Number | 1578104089 |
|---|---|
| Provider Enumeration Date | 10/06/2019 |
| Last Update Date | 02/09/2021 |
| Certification Date | 02/09/2021 |
| Medicare PECOS PAC ID | 2163850330 |
|---|---|
| Medicare Enrollment ID | O20200323000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578104089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ira Potashner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225341696 PECOS PAC ID: 3072941244 Enrollment ID: I20200323000311 |
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