Provider Demographics
NPI:1720118193
Name:ESTERMAN, JOEL (MED)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ESTERMAN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N BROAD ST
Mailing Address - Street 2:8TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1510
Mailing Address - Country:US
Mailing Address - Phone:215-568-0860
Mailing Address - Fax:215-568-0769
Practice Address - Street 1:112 N BROAD ST
Practice Address - Street 2:8TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1510
Practice Address - Country:US
Practice Address - Phone:215-568-0860
Practice Address - Fax:215-568-0769
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 002558-2103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist