Individual provider Active NPI

Maureen Zdanis, PH.D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1689192981
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018326 Issued in PA
Practice address
7600 Stenton Ave
Philadelphia, PA 19118-3231
Phone
(267) 250-9814
Fax
(267) 250-9814
NPI assigned
Sep 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS018326 PA Primary

Addresses

Primary practice location

7600 Stenton Ave
Philadelphia, PA 19118-3231

Mailing address

882 N Bucknell St
Philadelphia, PA 19130-1935
Phone (267) 250-9814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians PastSince Jan 18, 2018 Accepting new patients

Organizations & group practices 1

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": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1689192981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 N BUCKNELL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301935",
            "telephone_number": "267-250-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183231",
            "telephone_number": "267-250-9814",
            "fax_number": "267-250-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDANIS",
        "first_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.