Provider Demographics
NPI:1285419515
Name:WAIBEL, PHILIP
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:WAIBEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5718
Mailing Address - Country:US
Mailing Address - Phone:267-421-4006
Mailing Address - Fax:
Practice Address - Street 1:300 W BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3683
Practice Address - Country:US
Practice Address - Phone:855-687-2410
Practice Address - Fax:833-687-2414
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health