is a Psychiatry in Philadelphia, Pennsylvania. practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for is 1497706097. The last update date is .
's current location address is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. You can contact this provider via phone number 2158314600. The mailing address for is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 4641 Roosevelt Blvd, Philadelphia, Pennsylvania |
Phone Number | 2158314600 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1497706097 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 4641 Roosevelt Blvd |
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City | Philadelphia |
State | Pennsylvania (PA) |
Post Code | 191242343 |
Phone Number | 2158314600 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Psychiatry |
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Taxonomy | 2084P0800X |
Licence No | MD063094L |
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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MD063094L | PA | LICENSE NUMBER | |
18043020001 | PA | -- |
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