Provider Demographics
NPI:1346436375
Name:ADELMAN, SUSAN C (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:ADELMAN
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 1:469 WYNGATE RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2351
Mailing Address - Country:US
Mailing Address - Phone:610-645-7574
Mailing Address - Fax:
Practice Address - Street 1:28 GARRETT AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1400
Practice Address - Country:US
Practice Address - Phone:610-645-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007543L102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAD046584OtherBLUE CROSS/BLUE SHIELD