John A Abbruzzese III, PSYCHOLOGIST

Individual provider Active NPI Psychologist · Bethlehem, PA

NPI 1013547322 · NPPES record last updated Jan 26, 2020

Key facts

NPI
1013547322
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
PS004645L (PA)
Practice address
2638 West Blvd
Bethlehem, PA 18017-4038
Phone
(610) 954-8597
NPI assigned
Jan 26, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PS004645LPAMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS004645L PA Yes

Addresses

Primary practice location

2638 West Blvd
Bethlehem, PA 18017-4038

Mailing address

2638 West Blvd
Bethlehem, PA 18017-4038
Phone (610) 954-8597

Other providers in Bethlehem, PA

All providers in Bethlehem, PA · Psychologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.