| Memory Clinic, Inc. | |
|
357 Shields Dr Bennington VT 05201-9810 | |
| (802) 447-1409 | |
| Not Available |
| Full Name | Memory Clinic, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 357 Shields Dr, Bennington, Vermont |
| Authorized Official Name and Position | Cynthia Murphy (DIRECTOR) |
| Authorized Official Contact | 8024471409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memory Clinic, Inc. 357 Shields Dr Bennington VT 05201-9810 Ph: () - | Memory Clinic, Inc. 357 Shields Dr Bennington VT 05201-9810 Ph: (802) 447-1409 |
| NPI Number | 1205359213 |
|---|---|
| Provider Enumeration Date | 07/21/2017 |
| Last Update Date | 03/16/2021 |
| Certification Date | 03/16/2021 |
| Medicare PECOS PAC ID | 6709209109 |
|---|---|
| Medicare Enrollment ID | O20200701002464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205359213 | NPI | - | NPPES |
| Provider Name | Lisa Karen Catapano Friedman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619973690 PECOS PAC ID: 8123078490 Enrollment ID: I20050125000302 |
| Provider Name | Cynthia Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851483028 PECOS PAC ID: 9638129000 Enrollment ID: I20100824000866 |
| Provider Name | Diana E Michalczuk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760631774 PECOS PAC ID: 5193977585 Enrollment ID: I20121211000333 |
| Provider Name | Penny S Bruso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518376607 PECOS PAC ID: 5496078347 Enrollment ID: I20141229000763 |
| Provider Name | Guy Bernard Debros |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740687011 PECOS PAC ID: 7911227939 Enrollment ID: I20170106000653 |
| Provider Name | Courtnay Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982111241 PECOS PAC ID: 7911268693 Enrollment ID: I20180220001536 |
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