EDWARD A MAITZ (NPI# 1558381251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558381251 |
| Entity Type | Individual |
| Full Name | EDWARD A MAITZ |
| Credential | PHD |
| Practice Address |
117 S 17th St Suite 1700 Philadelphia PA 19103-5025 |
| Practice Telephone | 2158649444 |
| Practice Fax Number | 2158640244 |
| Mailing Telephone | 2158649444 |
| Mailing Fax Number | 2158640244 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 004599L | PA | Behavioral Health & Social Service Providers |
| Street Address |
117 S 17TH ST SUITE 1700 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19103-5025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952514374 | Raul Yankelevich | Family Medicine | 117 S 17th St, Suite 300, Philadelphia, PA 19103-5025 | 2007-05-08 |
| 1326164211 | Linda G. Ziman Dpm, PC | Podiatrist | 117 S 17th St, Philadelphia, PA 19103-5025 | 2007-03-22 |
| 1952441982 | Kevin V. Kelley | Specialist/Technologist, Other | 117 S 17th St, Suite 1902, Philadelphia, PA 19103-5025 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467092312 | Katie Fabius | Clinical Neuropsychologist | 230 S Broad St Ste 1005, Philadelphia, PA 19102-4105 | 2020-01-08 |
| 1609228022 | Michael E. Keesler | Clinical Neuropsychologist | 77 Rochelle Ave, Philadelphia, PA 19128-3809 | 2016-07-09 |
| 1023463106 | Chelsea Black | Clinical Neuropsychologist | 3405 Civic Center Blvd Rm 107, Philadelphia, PA 19104-4319 | 2016-04-26 |
| 1285088914 | Megan Alana Perrin | Clinical Neuropsychologist | 1510 Manton St, Philadelphia, PA 19146-3129 | 2016-04-19 |
| 1104207190 | Kelly M. Janke | Clinical Neuropsychologist | 3501 Civic Center Blvd # 10209, Philadelphia, PA 19104-3820 | 2015-06-15 |
| 1861637381 | Dr. Shan Psychiatry Clinic LLC | Clinical Neuropsychologist | 756 Adams Ave, Philadelphia, PA 19124-2330 | 2008-12-12 |
| 1225184468 | Cornelius Furgueson | Clinical Neuropsychologist | 1801 Vine St, Room 149-mg, Philadelphia, PA 19103-1117 | 2007-01-27 |
| 1588711006 | Diversified Psychological Resources, P.C. | Clinical Neuropsychologist | 230 S. Broad St., Suite 1005, Philadelphia, PA 19102-4105 | 2007-01-05 |
| 1407879430 | Carol L Armstrong | Clinical Neuropsychologist | 100 N 20th St, Philadelphia, PA 19103-1443 | 2006-07-25 |
| 1558380766 | Agnieszka A Kleczek | Clinical Neuropsychologist | 4621 Salmon St, Philadelphia, PA 19137-2123 | 2006-07-19 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.