Philadelphia Psychological Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD014418-E Issued in PA

Legal business name

PHILADELPHIA PSYCHOLOGICAL SERVICES

Practice address

4641 Roosevelt Blvd
Attn Michael Pertschuk MD
Philadelphia, PA 19124-2343

Phone

(215) 831-5367

NPI assigned

Jan 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennie Rolon

Title

Office Manager

Phone

(215) 831-5367

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346396736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "address_2": "ATTN MICHAEL PERTSCHUK MD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "address_2": "ATTN MICHAEL PERTSCHUK MD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLON",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-831-5367"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD014418-E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philadelphia Post Acute Partners, LLC (Good Shepherd Penn Partners Specialty Hospital at Rittenhouse)
• Philadelphia Post Acute Partners, LLC (Penn Medicine Good Shepherd Rehabilitation)
• Philadelphia Post-Acute Partners LLC (GSPP Physician Group)
• Philadelphia Premium Homecare LLC
• Philadelphia Protestant Home
• Philadelphia Psychotherapy Group
• Philadelphia Radiation Oncology, P.C.
• Philadelphia Recovery Solutions LLC
• Philadelphia Rehab Medc
• Philadelphia Rehabilitation & Sports Medicine

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.