Provider Demographics
NPI:1215971114
Name:NEUBERT, JOHN JOSEPH JR (PHD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:NEUBERT
Suffix:JR
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:PO BOX 201
Mailing Address - Street 2:JOHN NEUBERT PHD
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:412-418-0953
Mailing Address - Fax:412-418-0953
Practice Address - Street 1:8035 MCKNIGHT ROAD
Practice Address - Street 2:JOHN NEUBERT PHD
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-418-0953
Practice Address - Fax:412-364-4849
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005050L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA021623OtherBLUE SHIELD
PA01854823Medicaid
PA021623Medicare ID - Type Unspecified