Provider Demographics
NPI:1235327735
Name:CONTRACTOR, ATEKA A (PHD)
Entity type:Individual
Prefix:
First Name:ATEKA
Middle Name:A
Last Name:CONTRACTOR
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 1:3720 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4115
Mailing Address - Country:US
Mailing Address - Phone:844-210-0409
Mailing Address - Fax:
Practice Address - Street 1:3720 SPRUCE ST # 409
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4115
Practice Address - Country:US
Practice Address - Phone:844-210-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200880TMedicare PIN