Healthcare Provider Details

I. General information

NPI: 1861069882
Provider Name (Legal Business Name): ANDREW GILES MARKMAN GUZICK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OFFICE SUITE DRIVE SUITE 400
FORT WASHINGTON PA
19034-3234
US

IV. Provider business mailing address

1977 BUTLER BLVD STE 400
HOUSTON TX
77030-4101
US

V. Phone/Fax

Practice location:
  • Phone: 215-259-8234
  • Fax:
Mailing address:
  • Phone: 713-798-4857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS019601
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: