| Elizabeth J Buckley Phd Pa | |
|
310 Nw 76th Dr Ste A Gainesville FL 32607-6660 | |
| (352) 244-5422 | |
| Not Available |
| Full Name | Elizabeth J Buckley Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 310 Nw 76th Dr, Gainesville, Florida |
| Authorized Official Name and Position | Elizabeth J Buckley (PRESIDENT) |
| Authorized Official Contact | 3522445422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth J Buckley Phd Pa 310 Nw 76th Dr Ste A Gainesville FL 32607-6660 Ph: (352) 244-5422 | Elizabeth J Buckley Phd Pa 310 Nw 76th Dr Ste A Gainesville FL 32607-6660 Ph: (352) 244-5422 |
| NPI Number | 1245578376 |
|---|---|
| Provider Enumeration Date | 01/24/2013 |
| Last Update Date | 02/20/2013 |
| Medicare PECOS PAC ID | 8123263084 |
|---|---|
| Medicare Enrollment ID | O20130325000197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245578376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5732 (Florida) | Primary |
| Provider Name | Elizabeth Buckley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962416495 PECOS PAC ID: 8921045147 Enrollment ID: I20050409000052 |
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