Provider Demographics
NPI:1134519754
Name:PLUMMER, EDMUND (MA)
Entity type:Individual
Prefix:MR
First Name:EDMUND
Middle Name:
Last Name:PLUMMER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-1209
Mailing Address - Country:US
Mailing Address - Phone:215-847-9116
Mailing Address - Fax:
Practice Address - Street 1:633 N 57TH ST
Practice Address - Street 2:FIRST FLOOR, APT. 1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4805
Practice Address - Country:US
Practice Address - Phone:215-847-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst