Organization
ST. REGIS PSYCHOLOGICAL & EDUCATIONAL ASSOC.LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT JOHN GIOE PH.D. (PRESIDENT)
(215) 923-5803
Entity
Organization
Contact information
Practice address
822 PINE ST, SUITE 4A, PHILADELPHIA, PA 19107-6187
(215) 923-5803
(215) 923-5758
Mailing address
822 PINE ST, SUITE 4A, PHILADELPHIA, PA 19107-6187
(215) 923-5803
(215) 923-5758
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS002386-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063161000
BLUE SHIELD
PA
01
—
2907367
AETNA
PA
01
—
ST 888479
BLUE SHIELD
PA
Enumeration date
01/29/2007
Last updated
08/22/2020
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