Spectrum Psychology Services, Pllc | |
16108 E Emerald Dr Unit 204 Fountain Hills AZ 85268-5424 | |
(516) 978-8294 | |
Not Available |
Full Name | Spectrum Psychology Services, Pllc |
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Speciality | Psychologist |
Location | 16108 E Emerald Dr Unit 204, Fountain Hills, Arizona |
Authorized Official Name and Position | Anthony V Santoro (PSYCHOLOGIST) |
Authorized Official Contact | 5169788294 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Spectrum Psychology Services, Pllc 16108 E Emerald Dr Unit 204 Fountain Hills AZ 85268-5424 Ph: (516) 978-8294 | Spectrum Psychology Services, Pllc 16108 E Emerald Dr Unit 204 Fountain Hills AZ 85268-5424 Ph: (516) 978-8294 |
NPI Number | 1770520116 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 02/01/2023 |
Certification Date | 02/01/2023 |
Medicare PECOS PAC ID | 1052328713 |
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Medicare Enrollment ID | O20060321000627 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770520116 | NPI | - | NPPES |
02773311 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 013294 (New York) | Primary |
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
Provider Name | Anthony V Santoro |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1912941352 PECOS PAC ID: 2163493180 Enrollment ID: I20060322000087 |
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