Provider Demographics
NPI:1033284997
Name:SCHLESINGER, PETER MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MICHAEL
Last Name:SCHLESINGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:SCHLESINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:514 BABYLON RD
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2306
Mailing Address - Country:US
Mailing Address - Phone:215-646-0885
Mailing Address - Fax:215-646-4535
Practice Address - Street 1:514 BABYLON RD
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2306
Practice Address - Country:US
Practice Address - Phone:215-646-0885
Practice Address - Fax:215-646-4535
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002622-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS-002622-LOtherPSYCHOLOGY LICENSE
PASC507481Medicare ID - Type Unspecified