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NPI Code Detail

MEDICARE: MARIA MADDALO PSY.D.

MEDICARE:   MARIA  MADDALO  PSY.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
1103TC0700XClinical PsychologistPS018612PA
2103T00000XPsychologistPS018612PA

General Provider Information

NPI Number : 1568970879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA MADDALO PSY.D.
Provider Business Mailing Address
First Line : 390 COMMERCE DR
Second Line :
City : FORT WASHINGTON
State : PA
Zip : 19034-2600
Country : US
Telephone Number : 267-652-0203
Fax Number :
Provider Business Practice Location Address
First Line : 390 COMMERCE DR
Second Line :
City : FORT WASHINGTON
State : PA
Zip : 19034-2600
Country : US
Telephone Number : 267-652-0203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2018
Last Update Date : 10/02/2025

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