Healthcare Provider Details

I. General information

NPI: 1770618035
Provider Name (Legal Business Name): LAURIE ROBBINS APPELBAUM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CLARMONT AVE SUITE B MCC-WARWICK FAMILY SERVICES
BENSALEM PA
19020-5705
US

IV. Provider business mailing address

830 VILLAGE CIR
BLUE BELL PA
19422-1639
US

V. Phone/Fax

Practice location:
  • Phone: 267-275-7000
  • Fax: 267-525-7014
Mailing address:
  • Phone: 215-646-4206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD043497E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1157630
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: