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NPI Code Detail

MEDICARE: HANNAH BERGMAN BORDEN M.A.

MEDICARE: HANNAH BERGMAN BORDEN M.A.
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
1103T00000XPsychologistPS007366LPA

General Provider Information

NPI Number : 1235207291
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH BERGMAN BORDEN M.A.
Provider Business Mailing Address
First Line : 221 N 23RD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1005
Country : US
Telephone Number : 215-988-1220
Fax Number : 215-988-1220
Provider Business Practice Location Address
First Line : 221 N 23RD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1005
Country : US
Telephone Number : 215-988-1220
Fax Number : 215-988-1220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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