Provider Demographics
NPI:1528192770
Name:COLEMAN, RONALD E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:E
Last Name:COLEMAN
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 1:870 DELMONT DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2608
Mailing Address - Country:US
Mailing Address - Phone:610-642-1585
Mailing Address - Fax:
Practice Address - Street 1:1062 E LANCASTER AVE
Practice Address - Street 2:SUITE 23A
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1552
Practice Address - Country:US
Practice Address - Phone:610-642-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002548L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000808Medicare ID - Type Unspecified