Provider Demographics
NPI:1336279371
Name:GINESIN, STACEY ZOLONDEK (PHD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ZOLONDEK
Last Name:GINESIN
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 1:200 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-8400
Mailing Address - Country:US
Mailing Address - Phone:215-345-7868
Mailing Address - Fax:
Practice Address - Street 1:200 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-8400
Practice Address - Country:US
Practice Address - Phone:215-345-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015729103TF0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical