Provider Demographics
NPI:1568718088
Name:ADELMAN, BONNIE L (MSPA)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:L
Last Name:ADELMAN
Suffix:
Gender:F
Credentials:MSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:650 LANKENAU MEDICAL BLDG. EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-896-6800
Mailing Address - Fax:610-896-5627
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:650 LANKENAU MEDICAL BLDG. EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-896-6800
Practice Address - Fax:610-896-5627
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001075L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962439000Medicare PIN
PA1366484743Medicare PIN
PA1811924830Medicare PIN
PA1861539470Medicare PIN