| The Park Avenue Group Llc | |
|
857 Park Ave Baltimore MD 21201-4800 | |
| (410) 244-6633 | |
| Not Available |
| Full Name | The Park Avenue Group Llc |
|---|---|
| Speciality | Psychologist |
| Location | 857 Park Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Lynn Buhler (MANAGING MEMBER) |
| Authorized Official Contact | 4102446633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Park Avenue Group Llc 857 Park Ave Baltimore MD 21201-4800 Ph: (410) 244-6633 | The Park Avenue Group Llc 857 Park Ave Baltimore MD 21201-4800 Ph: (410) 244-6633 |
| NPI Number | 1720208218 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 04/02/2015 |
| Medicare PECOS PAC ID | 2961598735 |
|---|---|
| Medicare Enrollment ID | O20071010000355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720208218 | NPI | - | NPPES |
| Provider Name | Lynn L Buhler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376747840 PECOS PAC ID: 5496841264 Enrollment ID: I20071010000377 |
| Provider Name | Russell J Hibler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700842903 PECOS PAC ID: 0547345324 Enrollment ID: I20080305000061 |
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