MEDICARE: ADAM TANZER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PS015339	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS015339	OTHER	PA	LICENSE NUMBER

General Provider Information

NPI Number	:	1053342931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM TANZER PHD

Provider Business Mailing Address
First Line	:	301 OXFORD VALLEY RD STE 603A
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-7712
Country	:	US
Telephone Number	:	215-687-7899
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 OXFORD VALLEY RD STE 603A
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-7712
Country	:	US
Telephone Number	:	215-687-7899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	10/01/2020

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Directions to “ ADAM TANZER PHD” Practice Location

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