MEDICARE: DR. BARBARA FIELDS ED 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
1	103TC0700X	Clinical Psychologist	003411L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FI1747537	OTHER	PA	HIGHMARK
2	0049401000	OTHER	PA	PERSONAL CHOICE

General Provider Information

NPI Number	:	1821028317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA FIELDS ED D

Provider Business Mailing Address
First Line	:	8302 OLD YORK ROAD
Second Line	:	SUITE B1
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1529
Country	:	US
Telephone Number	:	215-885-6600
Fax Number	:	215-885-6614

Provider Business Practice Location Address
First Line	:	8302 OLD YORK ROAD
Second Line	:	SUITE B1
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1529
Country	:	US
Telephone Number	:	215-885-6600
Fax Number	:	215-885-6614

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/08/2007

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