George Medzerian PH.D. Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY3086 Issued in FL

Legal business name

GEORGE MEDZERIAN PH.D. INC.

Practice address

428 SW 7TH St
Stuart, FL 34994-2908

Phone

(772) 283-0013

Fax

(772) 219-4785

NPI assigned

Nov 16, 2010

Last updated

Nov 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Medzerian, PH.D.NPI 1134284920

Title

Psychologist

Phone

(772) 485-0235

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 2

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.

• George Medzerian, PH.D.

  • Clinical Psychologist
  • Stuart, FL
  • NPI 1134284920
  NPD Authorized official
• Kendra Brown, PH.D.

  • Psychologist
  • Stuart, FL
  • NPI 1861545667
  NPD (past)

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1568763944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 SW 7TH ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942908",
            "telephone_number": "772-283-0013",
            "fax_number": "772-219-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 SW 7TH ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942908",
            "telephone_number": "772-283-0013",
            "fax_number": "772-219-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE MEDZERIAN PH.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "MEDZERIAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "772-485-0235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "089002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRADMAN",
            "identifier": "FL2095",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5371572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "75859",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "215000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Stuart, FL
• Providers in Stuart, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.