Liza C Mermelstein Phd Llc | |
9426 Indian School Rd Ne Suite 1 Albuquerque NM 87112-2886 | |
(505) 345-6100 | |
(505) 345-4531 |
Full Name | Liza C Mermelstein Phd Llc |
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Speciality | Psychologist |
Location | 9426 Indian School Rd Ne, Albuquerque, New Mexico |
Authorized Official Name and Position | Liza Chytilo Mermelstein (MANAGING MEMBER) |
Authorized Official Contact | 6077689640 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Liza C Mermelstein Phd Llc 9426 Indian School Rd Ne Suite 1 Albuquerque NM 87112-2886 Ph: (505) 345-6100 | Liza C Mermelstein Phd Llc 9426 Indian School Rd Ne Suite 1 Albuquerque NM 87112-2886 Ph: (505) 345-6100 |
NPI Number | 1710387105 |
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Provider Enumeration Date | 09/04/2014 |
Last Update Date | 09/04/2014 |
Medicare PECOS PAC ID | 6002038726 |
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Medicare Enrollment ID | O20141113001680 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710387105 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 1347 (New Mexico) | Primary |
Provider Name | Liza C Mermelstein |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1679775076 PECOS PAC ID: 7517189244 Enrollment ID: I20141113001917 |
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