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1134415870
MICHAEL J MIKITISH
ELKINS PARK, PA
NPI
1134415870
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103G00000X Clinical Neuropsychologist
(Licence: PA PS004701L)
Enumeration Date
2011-06-21
Last Update Date
2011-06-21
Business Address
MICHAEL J MIKITISH PHD
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027-2220
Phone number: 215-831-2400
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Mailing Address
MICHAEL J MIKITISH PHD
101 E OLNEY AVE SUITE 400
PHILADELPHIA, PA 19120-2421
Phone number: 215-254-2630
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