Provider Demographics
NPI:1992386619
Name:MOSNER, MAYA GELMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:GELMAN
Last Name:MOSNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 MARKET ST STE 410
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3338
Mailing Address - Country:US
Mailing Address - Phone:856-200-0352
Mailing Address - Fax:
Practice Address - Street 1:3440 MARKET ST STE 410
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3338
Practice Address - Country:US
Practice Address - Phone:856-200-0352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019212103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent