Michael J Mikitish, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS004701L Issued in PA

Practice address

60 Township Line Rd
Elkins Park, PA 19027-2220

Phone

(215) 831-2400

NPI assigned

Jun 21, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1134415870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-254-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TOWNSHIP LINE RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272220",
            "telephone_number": "215-831-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKITISH",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS004701L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Schwartz, D.O. LLC
• Lucia A. Mettler, MSS/LSW
• Lowell D Meyerson, DO
• Michael D Birnbaum MD, PC
• Zorina Elsie Mikhelson, AU.D.
• Lee Stern Miller, M.F.T.
• Michael Brandon Miller, MS
• Yvonne O Miller, DMD
• Brittney R Mitchell-Winborne, COTA
• Michael H. Mittelman, O.D., M.P.H.

• Clinical Neuropsychologist in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.