Healthcare Provider Details

I. General information

NPI: 1467932061
Provider Name (Legal Business Name): BINDAL MAKWANA MEHMEL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BINDAL KIRANKUMAR MAKWANA

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MONUMENT RD STE 207
BALA CYNWYD PA
19004-1725
US

IV. Provider business mailing address

821 N 15TH ST APT 1
PHILADELPHIA PA
19130-2265
US

V. Phone/Fax

Practice location:
  • Phone: 818-446-2522
  • Fax:
Mailing address:
  • Phone: 215-900-7586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS019981
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: