Provider Demographics
NPI:1962594614
Name:GREATER PHILADELPHIA PSYCHOLOGICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:GREATER PHILADELPHIA PSYCHOLOGICAL ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-635-4242
Mailing Address - Street 1:449 N STERLING RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2013
Mailing Address - Country:US
Mailing Address - Phone:215-635-4242
Mailing Address - Fax:215-782-1547
Practice Address - Street 1:449 N STERLING RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2013
Practice Address - Country:US
Practice Address - Phone:215-635-4242
Practice Address - Fax:215-782-1547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003989-L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty