Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS-006446-L | PA |
Y | 103TC0700X | Clinical Psychologist | PS-006446-L | PA |
NPI | 1003863721 |
---|---|
Provider Name | Dr. Arthur M Nezu |
First Address | Philadelphia, PA 19147 |
Second Address | Philadelphia, PA 19147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 28/07/2010 |