Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACOB LEVI PRILUCK, PSYD
Active Sole ProprietorDR. JACOB LEVI PRILUCK, PSYD is a Clinical Neuropsychologist healthcare provider located in SPRINGFIELD, Virginia. NPI 1992289425 is currently active in the NPPES registry. Verify at CMS.
Clinical Neuropsychologist · SPRINGFIELD, VA
Registration Details
- NPI Number
- 1992289425
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 20, 2018 (7.9414797135749 yrs)
- Last Updated
- Jan 19, 2023
- Licenses
-
0810006056 (VA)0810006056 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6120 BRANDON AVESPRINGFIELD, VA, 221502522Browse VA providers · Browse ZIP 22150
- Phone
- 9177830634
- Primary Specialty
-
Clinical Neuropsychologist
103G00000X
- Additional Specialty
- Clinical Neuropsychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.