1962469940 NPI number — NELDA SHUMAN BOWERS LICENSED PSYCHOLOGIS

Table of content: NELDA SHUMAN BOWERS LICENSED PSYCHOLOGIS (NPI 1962469940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962469940 NPI number — NELDA SHUMAN BOWERS LICENSED PSYCHOLOGIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWERS
Provider First Name:
NELDA
Provider Middle Name:
SHUMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICENSED PSYCHOLOGIS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOWERS
Provider Other First Name:
NELL
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICENSED PSYCHOLOGIS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1962469940
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204 FARM LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOYLESTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18901-4714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-348-3379
Provider Business Mailing Address Fax Number:
215-348-8487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
204 FARM LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOYLESTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18901-4714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-348-3379
Provider Business Practice Location Address Fax Number:
215-348-8487
Provider Enumeration Date:
04/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PS 001156-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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