Provider Demographics
NPI: | 1346891736 |
---|---|
Name: | ROW PSYCHIATRIC SERVICES, LLC |
Entity type: | Organization |
Organization Name: | ROW PSYCHIATRIC SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROSEMARY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FORDJOUR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 610-999-1908 |
Mailing Address - Street 1: | 40 LLOYD AVE STE 206 |
Mailing Address - Street 2: | |
Mailing Address - City: | MALVERN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19355-3091 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 610-999-1908 |
Mailing Address - Fax: | 267-214-3250 |
Practice Address - Street 1: | 40 LLOYD AVE STE 206 |
Practice Address - Street 2: | |
Practice Address - City: | MALVERN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19355-3091 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-999-1908 |
Practice Address - Fax: | 267-214-3250 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-26 |
Last Update Date: | 2025-03-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |