| Blue Ridge Neuropsychology Pc | |
|
40 Lambert St Ste 222 Staunton VA 24401-2446 | |
| (540) 886-3956 | |
| (540) 886-3975 |
| Full Name | Blue Ridge Neuropsychology Pc |
|---|---|
| Speciality | Psychologist |
| Location | 40 Lambert St, Staunton, Virginia |
| Authorized Official Name and Position | Thomas V Ryan (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5408863956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Neuropsychology Pc 40 Lambert St Ste 222 Staunton VA 24401-2446 Ph: (540) 886-3956 | Blue Ridge Neuropsychology Pc 40 Lambert St Ste 222 Staunton VA 24401-2446 Ph: (540) 886-3956 |
| NPI Number | 1104287168 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 11/18/2016 |
| Medicare PECOS PAC ID | 9032498662 |
|---|---|
| Medicare Enrollment ID | O20161122001154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104287168 | NPI | - | NPPES |
| 1750554036 | Other | VA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810001474 (Virginia) | Primary |
| Provider Name | Thomas V Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750554036 PECOS PAC ID: 2264721562 Enrollment ID: I20160510000181 |
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