Healthcare Provider Details

I. General information

NPI: 1669649356
Provider Name (Legal Business Name): BERGMAN AND SHECHTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE SUITE 564 EAST
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE SUITE 564 EAST
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-2353
  • Fax:
Mailing address:
  • Phone: 610-642-2353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS003201L
License Number StatePA

VIII. Authorized Official

Name: JUDITH A SHECHTER
Title or Position: PARTNER
Credential: PHD
Phone: 610-642-2353