Provider Demographics
NPI:1003813981
Name:BENNETT, ARLENE P (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:P
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:ERDENHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7703
Mailing Address - Country:US
Mailing Address - Phone:215-233-2333
Mailing Address - Fax:215-233-5371
Practice Address - Street 1:1016 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:ERDENHEIM
Practice Address - State:PA
Practice Address - Zip Code:19038-7703
Practice Address - Country:US
Practice Address - Phone:215-233-2333
Practice Address - Fax:215-233-5371
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029319L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA#0070526170002Medicaid
PA1C 101871OtherHIGHMARK MEDICARE
PA2834801000OtherPERSONAL CHOICE & KEYSTON
PA99715OtherCBH
PA2834801000OtherIBX
PA2834801000OtherPERSONAL CHOICE & KEYSTON
PA99715OtherCBH