Active NPI
Institutional Psychiatric Consultation Services
- Psychiatry Physician
- Malvern, PA
National Provider Identifier
1861693673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD050187-L
- Legal business name
- INSTITUTIONAL PSYCHIATRIC CONSULTATION SERVICES
- Practice address
- 414 Paoli Pike
Malvern, PA 19355 - Phone
- (610) 651-0657
- Fax
- (610) 722-0704
- NPI assigned
- May 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dale Panzer, MD
- Title
- Chairman Owner
- Phone
- (610) 324-4930
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD050187-L | PA | Primary |
Addresses
Primary practice location
414 Paoli Pike
Malvern, PA 19355
Mailing address
414 Paoli Pine
Malvern, PA 19355-3311
Phone (610) 324-4930
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1564531200000",
"number": "1861693673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 PAOLI PINE",
"city": "MALVERN",
"state": "PA",
"postal_code": "193553311",
"telephone_number": "610-324-4930",
"fax_number": "610-722-0704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 PAOLI PIKE",
"city": "MALVERN",
"state": "PA",
"postal_code": "19355",
"telephone_number": "610-651-0657",
"fax_number": "610-722-0704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSTITUTIONAL PSYCHIATRIC CONSULTATION SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-30",
"last_updated": "2019-07-31",
"status": "A",
"authorized_official_last_name": "PANZER",
"authorized_official_first_name": "DALE",
"authorized_official_title_or_position": "CHAIRMAN OWNER",
"authorized_official_telephone_number": "610-324-4930",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD050187-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Malvern, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.