| Matthew Ventimiglia, Phd | |
|
3031 N Wilson Ave Royal Oak MI 48073-3580 | |
| (586) 872-3146 | |
| Not Available |
| Full Name | Matthew Ventimiglia, Phd |
|---|---|
| Speciality | Clinic/Center |
| Location | 3031 N Wilson Ave, Royal Oak, Michigan |
| Authorized Official Name and Position | Matthew J Ventimiglia (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5868723146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Ventimiglia, Phd 3031 N Wilson Ave Royal Oak MI 48073-3580 Ph: (586) 872-3146 | Matthew Ventimiglia, Phd 3031 N Wilson Ave Royal Oak MI 48073-3580 Ph: (586) 872-3146 |
| NPI Number | 1811639644 |
|---|---|
| Provider Enumeration Date | 04/12/2022 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 1658743091 |
|---|---|
| Medicare Enrollment ID | O20230210001024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811639644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Matthew James Ventimiglia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972851517 PECOS PAC ID: 9335472679 Enrollment ID: I20190531001308 |
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