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2121 S Mill Ave Ste 223 Tempe AZ 85282-2138 | |
(480) 766-6630 | |
Not Available |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 2121 S Mill Ave Ste 223, Tempe, Arizona |
Authorized Official Name and Position | Joshua J Lambert (PRACTITIONER) |
Authorized Official Contact | 8135414831 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10858 E. Cosmos Circle Scottsdale AZ 85255 Ph: (813) 541-4832 | 2121 S Mill Ave Ste 223 Tempe AZ 85282-2138 Ph: (480) 766-6630 |
NPI Number | 1760845523 |
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Provider Enumeration Date | 03/30/2016 |
Last Update Date | 04/06/2016 |
Medicare PECOS PAC ID | 3870882053 |
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Medicare Enrollment ID | O20160511000379 |
Identifier | Type | State | Issuer |
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1760845523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | 005117 (Arizona) | Primary |
Provider Name | Philip Vitelli |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1841395662 PECOS PAC ID: 4183604739 Enrollment ID: I20090914000689 |
Provider Name | Joel Salter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487831129 PECOS PAC ID: 6507920105 Enrollment ID: I20140722000874 |
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