Provider Demographics
NPI:1356440788
Name:FIELSTEIN, ELLIOT (PHD)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:FIELSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4123
Mailing Address - Country:US
Mailing Address - Phone:615-385-4635
Mailing Address - Fax:
Practice Address - Street 1:2203 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4123
Practice Address - Country:US
Practice Address - Phone:615-385-4635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2082103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
EXEMPTMedicare UPIN