Provider Demographics
NPI:1184698375
Name:LOWE, MARCIE GREENBERG (PHD)
Entity type:Individual
Prefix:DR
First Name:MARCIE
Middle Name:GREENBERG
Last Name:LOWE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARCIE
Other - Middle Name:NAN
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1009 QUILL LN
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-2519
Mailing Address - Country:US
Mailing Address - Phone:215-233-4593
Mailing Address - Fax:
Practice Address - Street 1:100 OLD YORK RD
Practice Address - Street 2:SUITE 1206
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3606
Practice Address - Country:US
Practice Address - Phone:215-886-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004063L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R06383Medicare UPIN
158120Medicare ID - Type Unspecified