1245375666 NPI number — MARGOLIS BERMAN BYRNE HEALTH PSYCHOLOGY, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245375666 NPI number — MARGOLIS BERMAN BYRNE HEALTH PSYCHOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARGOLIS BERMAN BYRNE HEALTH PSYCHOLOGY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245375666
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1015 CHESTNUT ST
Provider Second Line Business Mailing Address:
STE 901
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-4309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-592-0139
Provider Business Mailing Address Fax Number:
215-592-1675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1015 CHESTNUT ST
Provider Second Line Business Practice Location Address:
STE 901
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-4309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-592-0139
Provider Business Practice Location Address Fax Number:
215-592-1675
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FRIEDMAN
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE SEC TREASURER OFFICE MNGR
Authorized Official Telephone Number:
215-592-0139

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4477438 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 485456 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0139559000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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