Healthcare Provider Details

I. General information

NPI: 1578550869
Provider Name (Legal Business Name): MURRAY ALLAN COOPERSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 OLD YORK RD
ELKINS PARK PA
19027-3005
US

IV. Provider business mailing address

303 GREYHORSE RD
WILLOW GROVE PA
19090-2804
US

V. Phone/Fax

Practice location:
  • Phone: 215-546-6808
  • Fax: 215-830-1147
Mailing address:
  • Phone: 215-830-0790
  • Fax: 215-830-1147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS002691L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: