Provider Demographics
NPI:1912150830
Name:MARILYN DEUTSCH PHD & HENRI DEUTSCH
Entity Type:Organization
Organization Name:MARILYN DEUTSCH PHD & HENRI DEUTSCH
Other - Org Name:MARILYN DEUTSCH PHD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-586-4343
Mailing Address - Street 1:120 N ABINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKS GREEN
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2541
Mailing Address - Country:US
Mailing Address - Phone:570-586-4343
Mailing Address - Fax:570-586-2196
Practice Address - Street 1:120 N ABINGTON RD
Practice Address - Street 2:
Practice Address - City:CLARKS GREEN
Practice Address - State:PA
Practice Address - Zip Code:18411-2541
Practice Address - Country:US
Practice Address - Phone:570-586-4343
Practice Address - Fax:570-586-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003709L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADE042473Medicare Oscar/Certification
PA035924Medicare Oscar/Certification