Healthcare Provider Details

I. General information

NPI: 1578587580
Provider Name (Legal Business Name): DAVID SETH TREBICH M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 BALTIMORE PIKE SUITE 250
SPRINGFIELD PA
19064-3958
US

IV. Provider business mailing address

541 CENTRAL AVE
HAVERTOWN PA
19083-4233
US

V. Phone/Fax

Practice location:
  • Phone: 610-544-2110
  • Fax:
Mailing address:
  • Phone: 215-643-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000216
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: