Provider Demographics
NPI:1003001512
Name:ALLANOFF BRAVEMAN, NANCY (PSYD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ALLANOFF BRAVEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 MARKET ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3325
Mailing Address - Country:US
Mailing Address - Phone:215-590-7532
Mailing Address - Fax:215-590-4251
Practice Address - Street 1:34TH STREET & CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-7555
Practice Address - Fax:215-590-7387
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical