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General NPI Number Information
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NPI Number | 1306488234
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Entity Type | Individual
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Provider Name | MRS. GERALDINE B WISMER
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Gender | Female
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 1062 LANCASTER AVE SUITE 2 THE POSTPARTUM STRESS CENTER, LLC
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City | ROSEMONT
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State | PA
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Zip | 19010-1568
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Country | US
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Telephone | 610-525-7527
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Fax | 610-525-3997
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Provider Business Mailing Address
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Address Line | 1062 LANCASTER AVE SUITE 2 THE POSTPARTUM STRESS CENTER, LLC
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City | ROSEMONT
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State | PA
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Zip | 19010-1568
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Country | US
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Telephone | 610-525-7527
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Fax | 610-525-3997
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN165068L
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License Number State | PA
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