Provider Demographics
NPI:1548239841
Name:RAYMOND BRAUNSTEIN PH.D., PC
Entity Type:Organization
Organization Name:RAYMOND BRAUNSTEIN PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-659-7501
Mailing Address - Street 1:415 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2700
Mailing Address - Country:US
Mailing Address - Phone:215-659-7501
Mailing Address - Fax:215-322-1596
Practice Address - Street 1:415 DAVISVILLE RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2700
Practice Address - Country:US
Practice Address - Phone:215-659-7501
Practice Address - Fax:215-322-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002272L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAJ27127OtherAMERIHEALTH
PA2363571000OtherINDEPENDENCE BLUE CROSS
PA4594800OtherAETNA
PA4594800OtherAETNA