Organization
FAMILY HEALTH PSYCHOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE GRACI (BILLING MANAGER)
(610) 524-1552
Entity
Organization
Contact information
Practice address
506 W MOUNT AIRY AVE, PHILADELPHIA, PA 19119-2948
(610) 237-5444
Mailing address
506 W MOUNT AIRY AVE, PHILADELPHIA, PA 19119-2948
(610) 237-5444
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0278173000
PERSONAL CHOICE
PA
05
—
10076199650006
—
PA
01
—
7761157
AETNA
PA
01
—
CI9140
RAILROAD MEDICARE
PA
Enumeration date
02/11/2007
Last updated
08/11/2008
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