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General NPI Number Information
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NPI Number | 1922021245
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Entity Type | Individual
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Provider Name | ANDREA MECHANICK BRAVERMAN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 111 MADISON AVE SUITE 100
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6097
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Country | US
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Telephone | 973-656-2862
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Fax |
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Provider Business Mailing Address
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Address Line | 834 CHESTNUT ST SUITE 400
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5127
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Country | US
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Telephone | 215-955-9216
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS-005298-L
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License Number State | PA
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