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
| License | State | Type | Specialty |
|---|---|---|---|
| PS004645L | PA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Osman Abbasi
- Rama Devi Abbireddy
- Kristin Abbruzzi
- Leyla A Abdulhay
- Abe Dental PC
- Abel a. Gonzalez, MD.PC
- Lynda Abi-Daher
All providers in Bethlehem, PA · Psychologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.