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NPI Code Detail

MEDICARE: DR. SUSAN C ADELMAN PH.D.

MEDICARE: DR. SUSAN C ADELMAN PH.D.
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
1102L00000XPsychoanalystPS007543LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AD046584OTHERPABLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1346436375
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN C ADELMAN PH.D.
Provider Business Mailing Address
First Line : 469 WYNGATE RD
Second Line :
City : WYNNEWOOD
State : PA
Zip : 19096-2351
Country : US
Telephone Number : 610-645-7574
Fax Number :
Provider Business Practice Location Address
First Line : 28 GARRETT AVE
Second Line :
City : BRYN MAWR
State : PA
Zip : 19010-1400
Country : US
Telephone Number : 610-645-7475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2007
Last Update Date : 09/24/2007

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