Provider Demographics
NPI:1215170964
Name:DON G SERAYDARIAN PHD & ASSOCIATES LLC
Entity type:Organization
Organization Name:DON G SERAYDARIAN PHD & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:G
Authorized Official - Last Name:SERAYDARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-860-0848
Mailing Address - Street 1:1705 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1009
Mailing Address - Country:US
Mailing Address - Phone:215-860-0848
Mailing Address - Fax:215-860-1244
Practice Address - Street 1:1705 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1009
Practice Address - Country:US
Practice Address - Phone:215-860-0848
Practice Address - Fax:215-860-1244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003336-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000097477Medicare PIN