Provider Demographics
NPI:1881931962
Name:SIEGLER, JOHN RUFE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RUFE
Last Name:SIEGLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-3404
Mailing Address - Country:US
Mailing Address - Phone:215-855-7859
Mailing Address - Fax:
Practice Address - Street 1:622 W MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-3404
Practice Address - Country:US
Practice Address - Phone:215-855-7859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA016154103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical