Healthcare Provider Details

I. General information

NPI: 1003988429
Provider Name (Legal Business Name): FRANK SERGI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 N BROAD ST
COLMAR PA
18915
US

IV. Provider business mailing address

2321 N BROAD ST
COLMAR PA
18915
US

V. Phone/Fax

Practice location:
  • Phone: 215-997-3600
  • Fax: 215-997-9409
Mailing address:
  • Phone: 215-997-3600
  • Fax: 215-997-9409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS006212L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: