Provider Demographics
NPI:1083821474
Name:GAMBESCIA, NANCY (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:GAMBESCIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 E LANCASTER AVE STE 26
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1565
Mailing Address - Country:US
Mailing Address - Phone:610-525-1978
Mailing Address - Fax:
Practice Address - Street 1:1062 E LANCASTER AVE STE 26
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1565
Practice Address - Country:US
Practice Address - Phone:610-525-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACERTIFICATION106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2147913000OtherINDEPENDENCE BLUE CROSS