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General NPI Number Information
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NPI Number | 1154593218
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Entity Type | Individual
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Provider Name | JODY SYSLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 1701 LANGHORNE NEWTOWN RD VICTORIAN COMMONS
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City | LANGHORNE
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State | PA
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Zip | 19047-1003
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Country | US
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Telephone | 215-968-5908
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Fax | 215-579-9469
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Provider Business Mailing Address
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Address Line | 509 COACHWOOD CT
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City | NEWTOWN
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State | PA
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Zip | 18940-4203
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Country | US
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Telephone | 215-968-5908
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Fax | 215-579-9469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS015105
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License Number State | PA
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