Ethan Berkson
Individual provider Active NPI Recreation Therapist · Phoenix, AZ
NPI 1235909375 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1235909375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Recreation Therapist 225800000X
- Practice address
- 650 E Indian School Rd
Phoenix, AZ 85012-1839 - Phone
- (602) 277-5551
- NPI assigned
- Jan 8, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | AZ | Yes |
Addresses
Primary practice location
650 E Indian School Rd
Phoenix, AZ 85012-1839
Mailing address
650 E Indian School Rd
Phoenix, AZ 85012-1839
Other providers in Phoenix, AZ
- Erik Earl Berkley
- Patricia Berkley
- Troy Berkley
- Michael Berkshire
- Stephanie Berkshire
- Anthony Berland
- Cynthia Berland
- Howard Scott Berlin
- Amanda Berliner
- Michele Berlinger
All providers in Phoenix, AZ · Recreation Therapist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. 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.