Provider Demographics
NPI:1922187707
Name:INTERNET BEHAVIORAL CARE, P.C.
Entity Type:Organization
Organization Name:INTERNET BEHAVIORAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-904-0080
Mailing Address - Street 1:521 PLYMOUNT ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1638
Mailing Address - Country:US
Mailing Address - Phone:610-265-6464
Mailing Address - Fax:
Practice Address - Street 1:521 PLYMOUTH ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1638
Practice Address - Country:US
Practice Address - Phone:610-265-6464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty