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NPI Code Detail

MEDICARE: KENNETH ALAN SPERLING PHD

MEDICARE: KENNETH ALAN SPERLING PHD
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
1103T00000XPsychologistPS002218LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10205168000OTHERINDEPENDENCE BLUE CROSS

General Provider Information

NPI Number : 1952461014
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH ALAN SPERLING PHD
Provider Business Mailing Address
First Line : 444 NORTH YORK RD
Second Line :
City : HATBORO
State : PA
Zip : 19040-2102
Country : US
Telephone Number : 215-672-1442
Fax Number : 215-672-0288
Provider Business Practice Location Address
First Line : 444 NORTH YORK RD
Second Line :
City : HATBORO
State : PA
Zip : 19040-2102
Country : US
Telephone Number : 215-672-1442
Fax Number : 215-672-0288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ KENNETH ALAN SPERLING PHD” Practice Location

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