Clinical Neuropsychology Associates, P.C.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

004599L Issued in PA

Legal business name

CLINICAL NEUROPSYCHOLOGY ASSOCIATES, P.C.

Practice address

1528 Walnut St
Suite 1500
Philadelphia, PA 19102-3604

Phone

(215) 735-2505

Fax

(215) 735-2504

NPI assigned

Jan 31, 2007

Last updated

Oct 5, 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

Edward Maitz, PHD

Title

Treasurer

Phone

(215) 735-2505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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.

• Joely Esposito, PSYD

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1740354737
  Medicare reassignment

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1972640928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189250359",
            "telephone_number": "215-735-2505",
            "fax_number": "215-735-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023604",
            "telephone_number": "215-735-2505",
            "fax_number": "215-735-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL NEUROPSYCHOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "MAITZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "215-735-2505",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "004599L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.