NPI 1134415870

Michael J Mikitish, PHD

Practitioner Clinical Neuropsychologist Elkins Park, PA

Practice location

Address: 60 Township Line Rd, Elkins Park, PA 19027-2220
Phone: (215) 831-2400
Mailing address: 101 E Olney Ave Suite 400, Philadelphia, PA 19120-2421

Registered specialties

Clinical Neuropsychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103G00000X Licence PS004701L (PA)

Other Clinical Neuropsychologist providers in Pennsylvania →

Registry record

NPI: 1134415870
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jun 2011
Record last updated: 21 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.