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NPI Code Detail

MEDICARE: DR. CLAIRE RODGERS PSYD

MEDICARE: DR. CLAIRE RODGERS PSYD
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
1103TC0700XClinical Psychologist018935PA

General Provider Information

NPI Number : 1417583410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLAIRE RODGERS PSYD
Provider Business Mailing Address
First Line : 931 CARPENTER ST # 2F
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-3805
Country : US
Telephone Number : 203-856-8377
Fax Number :
Provider Business Practice Location Address
First Line : 2566 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-1743
Country : US
Telephone Number : 203-856-8377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2020
Last Update Date : 03/21/2020

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