Provider Demographics
NPI:1316996838
Name:THE NEUROPSYCHOLOGY ASSESSMENT CENTER AT WIDENER UNIVERSITY
Entity type:Organization
Organization Name:THE NEUROPSYCHOLOGY ASSESSMENT CENTER AT WIDENER UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP FOR ADMINISTRATION & FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-499-4151
Mailing Address - Street 1:1 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5700
Mailing Address - Country:US
Mailing Address - Phone:610-499-4151
Mailing Address - Fax:610-499-4544
Practice Address - Street 1:1 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5700
Practice Address - Country:US
Practice Address - Phone:610-499-4151
Practice Address - Fax:610-499-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)