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General NPI Number Information
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NPI Number | 1548330798
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Entity Type | Individual
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Provider Name | DAVID KANNERSTEIN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 93 OLD YORK RD SUITE 203
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City | JENKINTOWN
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State | PA
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Zip | 19046-3925
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Country | US
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Telephone | 215-885-3337
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Fax | 215-885-3090
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Provider Business Mailing Address
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Address Line | 4103 FOUNTAIN GREEN RD
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-1214
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Country | US
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Telephone | 215-680-4505
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSOO6413-L
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License Number State | PA
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