Provider Demographics
NPI:1609972470
Name:BERLINERBLAU, MICHELE MOUSSIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MOUSSIA
Last Name:BERLINERBLAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:325 CHESTNUT ST
Mailing Address - Street 2:STE 905
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:215-829-0666
Mailing Address - Fax:215-351-3984
Practice Address - Street 1:325 CHESTNUT ST
Practice Address - Street 2:STE 905
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-829-0666
Practice Address - Fax:215-351-3984
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD040689L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry