Provider Demographics
NPI:1295765220
Name:GEVER, BENSON EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:BENSON
Middle Name:EDWARD
Last Name:GEVER
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 1:4232 MECHANICSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18934
Mailing Address - Country:US
Mailing Address - Phone:215-794-8583
Mailing Address - Fax:215-794-2151
Practice Address - Street 1:4232 MECHANICSVILLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18934
Practice Address - Country:US
Practice Address - Phone:215-794-8583
Practice Address - Fax:215-794-2151
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS001082L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA140163Medicaid
PA140163Medicaid
PA114869Medicare ID - Type Unspecified