Individual
DR. GERALD F. BELLETTIRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
920 N BROAD ST, LANSDALE, PA 19446-2351
(215) 362-1280
Mailing address
920 N BROAD ST, LANSDALE, PA 19446-2351
(215) 362-1280
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS003646-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BE189307
BLUE SHIELD
PA
Enumeration date
10/11/2006
Last updated
07/09/2007
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