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General NPI Number Information
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NPI Number | 1962594614
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Entity Type | Organization
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Legal Business Name | GREATER PHILADELPHIA PSYCHOLOGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 449 N STERLING RD
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City | ELKINS PARK
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State | PA
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Zip | 19027-2013
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Country | US
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Telephone | 215-635-4242
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Fax | 215-782-1547
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Provider Business Mailing Address
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Address Line | 449 N STERLING RD
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City | ELKINS PARK
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State | PA
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Zip | 19027-2013
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Country | US
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Telephone | 215-635-4242
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Fax | 215-782-1547
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Authorized Official
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Title or Position | CEO
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Name | CAROLINE M BACHMAN
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Credential | PHD
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Telephone | 215-635-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PS003989-L
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License Number State | PA
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