MEDICARE: URBAN HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PS-003982-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801807508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URBAN HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	19 N LANSDOWNE AVE
Second Line	:
City	:	LANSDOWNE
State	:	PA
Zip	:	19050-2205
Country	:	US
Telephone Number	:	484-461-8780
Fax Number	:	484-461-8025

Provider Business Practice Location Address
First Line	:	19 N LANSDOWNE AVE
Second Line	:
City	:	LANSDOWNE
State	:	PA
Zip	:	19050-2205
Country	:	US
Telephone Number	:	484-461-8780
Fax Number	:	484-461-8025

Authorized Official
Title or Position	:	PSYCHOLOGIST EXECUTIVE DIRECTOR
Name	:	DR. EARLE DANIEL MCNEILL
Credential	:	ED.D.
Telephone Number	:	484-461-8780

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	06/16/2008

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Directions to “URBAN HEALTH SERVICES, INC. ” Practice Location

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