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Individual

DR. JEFFREY LAWRENCE EIBERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1326 SPRUCE ST, SUITE #1905, PHILADELPHIA, PA 19107-5826
(215) 546-1767
Mailing address
1326 SPRUCE ST, SUITE #1905, PHILADELPHIA, PA 19107-5826
(215) 546-1767

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PA LIC. #PS002959L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0063120000
BC PERSONAL CHOICE
PA
01
246945000
MAGELLAN HEALTH CARE
PA
01
4365980
AETNA HEALTH CARE
PA
01
438240
HIGHMARK BLUE SHEILD
PA
Enumeration date
01/21/2006
Last updated
07/08/2007
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