Provider Demographics
NPI:1932118809
Name:BELL, I. BARRY (PHD)
Entity Type:Individual
Prefix:
First Name:I.
Middle Name:BARRY
Last Name:BELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3421
Mailing Address - Country:US
Mailing Address - Phone:215-482-4827
Mailing Address - Fax:215-482-4828
Practice Address - Street 1:1305 MEDFORD RD
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2418
Practice Address - Country:US
Practice Address - Phone:215-482-4827
Practice Address - Fax:215-482-4828
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005231L103G00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001549030-0007Medicaid
PA001549030-0007Medicaid
PAR89252Medicare UPIN