Provider Demographics
NPI:1578623260
Name:ORR, GERALD H (MA)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:H
Last Name:ORR
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1150 BERKSHIRE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-373-7005
Mailing Address - Fax:610-373-8005
Practice Address - Street 1:1150 BERKSHIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-373-7005
Practice Address - Fax:610-373-8005
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPS001175L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009382060001Medicaid
02996801OtherCAP BC
077892OtherHIGHMARK BLUE SHIELD
PA1009382060001Medicaid