NPIMap

Organization Active NPI

Professional Profiles

  • Clinical Neuropsychologist
  • Cotuit, MA
National Provider Identifier
1235434804
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
PROFESSIONAL PROFILES
Practice address
1860 Santuit Newtown Rd
Cotuit, MA 02635-2509
Phone
(508) 548-8989
Fax
(508) 548-5789
NPI assigned
Jan 12, 2011
Last updated
Jan 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Gerald P Elovitz, ED.D.NPI 1881666733
Title
General Partner
Phone
(508) 548-8989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

1860 Santuit Newtown Rd
Cotuit, MA 02635-2509

Mailing address

1860 Santuit Newtown Rd
Cotuit, MA 02635-2509
Phone (508) 548-8989

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1235434804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SANTUIT NEWTOWN RD",
            "city": "COTUIT",
            "state": "MA",
            "postal_code": "026352509",
            "telephone_number": "508-548-8989",
            "fax_number": "508-548-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SANTUIT NEWTOWN RD",
            "city": "COTUIT",
            "state": "MA",
            "postal_code": "026352509",
            "telephone_number": "508-548-8989",
            "fax_number": "508-548-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PROFILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "ELOVITZ",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "508-548-8989",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cotuit, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.