Provider Demographics
NPI:1992841225
Name:NORTHERN ARIZONA NEUROPSYCHOLOGY PC
Entity Type:Organization
Organization Name:NORTHERN ARIZONA NEUROPSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:ZARSKE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, ABPN
Authorized Official - Phone:928-779-3478
Mailing Address - Street 1:616 N BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3012
Mailing Address - Country:US
Mailing Address - Phone:928-779-3478
Mailing Address - Fax:928-774-6950
Practice Address - Street 1:616 N BEAVER ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3012
Practice Address - Country:US
Practice Address - Phone:928-779-3478
Practice Address - Fax:928-774-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ973103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty