Provider Demographics
NPI:1487109641
Name:MARPLE NEWTOWN SCHOOL DISTRICT
Entity type:Organization
Organization Name:MARPLE NEWTOWN SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PUPIL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RODICHOK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-359-4261
Mailing Address - Street 1:38 MEDIA LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38 MEDIA LINE RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4601
Practice Address - Country:US
Practice Address - Phone:610-358-4261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003477L251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS003477LOtherPT 19 LICENSED PSYCHOLOGIST