Provider Demographics
NPI:1568684314
Name:HERMAN, ELLEN N (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:N
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TERRY DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1872
Mailing Address - Country:US
Mailing Address - Phone:215-504-3971
Mailing Address - Fax:
Practice Address - Street 1:105 TERRY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1872
Practice Address - Country:US
Practice Address - Phone:215-504-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4213912084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry