| Robert Bastanfar Phd Lp | |
|
4660 Marsh Rd Room 28 Okemos MI 48864-2143 | |
| (517) 749-1356 | |
| Not Available |
| Full Name | Robert Bastanfar Phd Lp |
|---|---|
| Speciality | Psychologist |
| Location | 4660 Marsh Rd, Okemos, Michigan |
| Authorized Official Name and Position | Robert Bastanfar (PSYCHOLOGIST) |
| Authorized Official Contact | 5177491356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Bastanfar Phd Lp 4660 Marsh Rd Room 28 Okemos MI 48864-2143 Ph: () - | Robert Bastanfar Phd Lp 4660 Marsh Rd Room 28 Okemos MI 48864-2143 Ph: (517) 749-1356 |
| NPI Number | 1497168264 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 07/31/2020 |
| Certification Date | 07/31/2020 |
| Medicare PECOS PAC ID | 1759501166 |
|---|---|
| Medicare Enrollment ID | O20141007002470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497168264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Robert Bastanfar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992085534 PECOS PAC ID: 5799945135 Enrollment ID: I20120322000412 |
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