MEDICARE: DR. BRIAN MORAN 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
1	103TC0700X	Clinical Psychologist	PS018594	PA

General Provider Information

NPI Number	:	1821570243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN MORAN PSYD

Provider Business Mailing Address
First Line	:	1121 N BETHLEHEM PIKE
Second Line	:	STE 60, #219
City	:	SPRING HOUSE
State	:	PA
Zip	:	19477-1102
Country	:	US
Telephone Number	:	215-532-5024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 N BETHLEHEM PIKE
Second Line	:	STE 60, #219
City	:	SPRING HOUSE
State	:	PA
Zip	:	19477-1102
Country	:	US
Telephone Number	:	215-532-5024
Fax Number	:

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

Provider Enumeration Date	:	09/01/2018
Last Update Date	:	05/10/2024

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