| Jonathan A. Moselle,ph.d. P.c | |
|
1244 Ft Wshngtn Ave Suite K Ft Washington PA 19034-1743 | |
| (215) 643-2999 | |
| (215) 643-4599 |
| Full Name | Jonathan A. Moselle,ph.d. P.c |
|---|---|
| Speciality | Psychologist |
| Location | 1244 Ft Wshngtn Ave, Ft Washington, Pennsylvania |
| Authorized Official Name and Position | Jonathan A. Moselle (PRESIDENT) |
| Authorized Official Contact | 2156432999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan A. Moselle,ph.d. P.c 1244 Ft Wshngtn Ave Suite K Ft Washington PA 19034-1743 Ph: (215) 643-2999 | Jonathan A. Moselle,ph.d. P.c 1244 Ft Wshngtn Ave Suite K Ft Washington PA 19034-1743 Ph: (215) 643-2999 |
| NPI Number | 1841556909 |
|---|---|
| Provider Enumeration Date | 04/03/2012 |
| Last Update Date | 04/03/2012 |
| Medicare PECOS PAC ID | 6204094220 |
|---|---|
| Medicare Enrollment ID | O20120222000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841556909 | NPI | - | NPPES |
| 189672 | Other | PA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS003458L (Pennsylvania) | Primary |
| Provider Name | Jonathan A Moselle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841350683 PECOS PAC ID: 4688835598 Enrollment ID: I20120419000348 |
Tlc Wholeness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 426 Pennsylvania Ave, Ste 101, Ft Washington, PA 19034 Phone: 215-620-7660 Fax: 215-773-0789 |