Provider Demographics
NPI:1992802029
Name:BRAUNSTEIN, RAYMOND (PHD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2700
Mailing Address - Country:US
Mailing Address - Phone:215-659-7501
Mailing Address - Fax:215-322-1596
Practice Address - Street 1:415 DAVISVILLE RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2700
Practice Address - Country:US
Practice Address - Phone:215-659-7501
Practice Address - Fax:215-322-1596
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002272L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0049146000OtherINDEPENDENCE BLUE CROSS
PA027127OtherHIGHMARK
PA4594800OtherAETNA
PAJ27127OtherAMERIHEALTH
PA027127T51Medicare ID - Type Unspecified