Provider Demographics
NPI:1023176179
Name:ZUKERMAN, BARBARA (MA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:ZUKERMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 BUSTLETON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1188
Mailing Address - Country:US
Mailing Address - Phone:215-671-0766
Mailing Address - Fax:
Practice Address - Street 1:14500 BUSTLETON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1188
Practice Address - Country:US
Practice Address - Phone:215-671-0766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004879L103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist