Provider Demographics
NPI:1356434971
Name:MARVIN H. BERMAN & ASSOCIATES PC
Entity type:Organization
Organization Name:MARVIN H. BERMAN & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-940-0488
Mailing Address - Street 1:521 PLYMOUTH RD
Mailing Address - Street 2:STE. 111
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1638
Mailing Address - Country:US
Mailing Address - Phone:610-940-0488
Mailing Address - Fax:215-359-0630
Practice Address - Street 1:521 PLYMOUTH RD
Practice Address - Street 2:STE. 111
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1638
Practice Address - Country:US
Practice Address - Phone:610-940-0488
Practice Address - Fax:215-359-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006663-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA084405Medicare PIN