Provider Demographics
NPI:1225252620
Name:CAPE COD NEUROPSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:CAPE COD NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACUNZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-888-6869
Mailing Address - Street 1:68 TUPPER RD # 8
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-1872
Mailing Address - Country:US
Mailing Address - Phone:508-888-6869
Mailing Address - Fax:508-888-5994
Practice Address - Street 1:68 TUPPER RD # 8
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-1872
Practice Address - Country:US
Practice Address - Phone:508-888-6869
Practice Address - Fax:508-888-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7030103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty