Provider Demographics
NPI:1558917880
Name:ASSOIAN, ADAM BENJAMIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:BENJAMIN
Last Name:ASSOIAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 ANTHEM WAY
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-1931
Mailing Address - Country:US
Mailing Address - Phone:201-693-5608
Mailing Address - Fax:
Practice Address - Street 1:5049 SWAMP RD STE 303
Practice Address - Street 2:
Practice Address - City:FOUNTAINVILLE
Practice Address - State:PA
Practice Address - Zip Code:18923-9660
Practice Address - Country:US
Practice Address - Phone:267-432-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018842103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist