Organization
JONATHAN A. MOSELLE,PH.D. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN A. MOSELLE PH.D. (PRESIDENT)
(215) 643-2999
Entity
Organization
Contact information
Practice address
1244 FT WSHNGTN AVE, SUITE K, FT WASHINGTON, PA 19034-1743
(215) 643-2999
(215) 643-4599
Mailing address
1244 FT WSHNGTN AVE, SUITE K, FT WASHINGTON, PA 19034-1743
(215) 643-2999
(215) 643-4599
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS003458L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189672
MEDICARE PTAN
PA
Enumeration date
04/03/2012
Last updated
04/03/2012
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