Provider Demographics
NPI:1811052038
Name:BREITMAN, BARBARA EVE (MSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:EVE
Last Name:BREITMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3112
Mailing Address - Country:US
Mailing Address - Phone:215-843-3354
Mailing Address - Fax:
Practice Address - Street 1:3900 CITY AVE
Practice Address - Street 2:SUITE 117D
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2908
Practice Address - Country:US
Practice Address - Phone:215-877-6202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 106H00000X
PACW-00001387-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA645223Medicare ID - Type Unspecified