Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Vaux Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET FERRARIE (CREDENTIALING MANAGER)
(215) 707-2433
Entity
Organization
Contact information
Practice address
2300 W MASTER ST STE 109B, PHILADELPHIA, PA 19121-4739
(215) 707-0499
(215) 707-0480
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-2433
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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