Provider Demographics
NPI:1235476078
Name:DR. DAVID T. WEIBEL & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR. DAVID T. WEIBEL & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WEIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-779-5575
Mailing Address - Street 1:14 S BRYN MAWR AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3216
Mailing Address - Country:US
Mailing Address - Phone:215-779-5575
Mailing Address - Fax:215-220-2686
Practice Address - Street 1:14 S BRYN MAWR AVE STE 203
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3216
Practice Address - Country:US
Practice Address - Phone:215-779-5575
Practice Address - Fax:215-220-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1649404096OtherNPI FOR DR. WEIBEL, THE ONLY PROVIDER IN DR. WEIBEL & ASSOCIATES
LA4P973OtherMEDICARE PTAN
LA470577YMH9Medicare PIN