Individual provider Active NPI

Reem A Tarazi, PH.D.

  • Clinical Neuropsychologist
  • Bryn Mawr, PA
National Provider Identifier
1598983645
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS016079 Issued in PA
Practice address
940 E Haverford Rd Ste 202
Bryn Mawr, PA 19010-3845
Phone
(267) 217-3003
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016079 PA
Clinical Neuropsychologist 103G00000X PS016079 PA Primary

Addresses

Primary practice location

940 E Haverford Rd Ste 202
Bryn Mawr, PA 19010-3845

Mailing address

940 E Haverford Rd Ste 202
Bryn Mawr, PA 19010-3845
Phone (267) 217-3003

Other identifiers 1

IdentifierTypeStateIssuer
101896236MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS016079PAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 1, 2020 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Tower Drexel Academic Medical Group LLC Current Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Drexel University Current Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 1, 2020 Accepting new patients
Phoenixville Specialty Clinics, LLC Past Accepting new patients

Locations

4641 E Roosevelt Blvd
Rm C229
Philadelphia, PA 19124

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

160 E Erie Ave
Fl 2
Philadelphia, PA 19134
Phone (215) 427-5569

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1598983645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E HAVERFORD RD STE 202",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103845",
            "telephone_number": "267-217-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E HAVERFORD RD STE 202",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103845",
            "telephone_number": "267-217-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARAZI",
        "first_name": "REEM",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016079",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS016079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101896236",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.