Healthcare Provider Details

I. General information

NPI: 1184698375
Provider Name (Legal Business Name): MARCIE GREENBERG LOWE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARCIE NAN GREENBERG PH.D.

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OLD YORK RD SUITE 1206
JENKINTOWN PA
19046-3606
US

IV. Provider business mailing address

1009 QUILL LN
ORELAND PA
19075-2519
US

V. Phone/Fax

Practice location:
  • Phone: 215-886-2200
  • Fax:
Mailing address:
  • Phone: 215-233-4593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS004063L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: