Provider Demographics
NPI:1467786665
Name:FRANKEL, WALTER B (PHD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:B
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 W AFTON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1421
Mailing Address - Country:US
Mailing Address - Phone:215-321-6819
Mailing Address - Fax:
Practice Address - Street 1:90 W AFTON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1421
Practice Address - Country:US
Practice Address - Phone:215-321-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI01583103T00000X
PAPS004026-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ87316190JMedicaid