Provider Demographics
NPI:1407869357
Name:RATTAN, ARLENE I (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:I
Last Name:RATTAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4436
Mailing Address - Country:US
Mailing Address - Phone:412-856-0402
Mailing Address - Fax:412-372-0430
Practice Address - Street 1:3825 NORTHERN PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2161
Practice Address - Country:US
Practice Address - Phone:412-856-0402
Practice Address - Fax:412-372-0430
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005555L103G00000X, 103TB0200X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01726082Medicaid
PAAR603170Medicare ID - Type Unspecified