Dr. Shan Psychiatry Clinic Llc | |
756 Adams Ave Philadelphia PA 19124-2330 | |
(215) 533-3660 | |
(215) 533-3682 |
Full Name | Dr. Shan Psychiatry Clinic Llc |
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Speciality | Clinical Neuropsychologist |
Location | 756 Adams Ave, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Yang Shan (DIRECTOR) |
Authorized Official Contact | 2155333660 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr. Shan Psychiatry Clinic Llc 756 Adams Ave Philadelphia PA 19124-2330 Ph: (215) 533-3660 | Dr. Shan Psychiatry Clinic Llc 756 Adams Ave Philadelphia PA 19124-2330 Ph: (215) 533-3660 |
NPI Number | 1861637381 |
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Provider Enumeration Date | 12/12/2008 |
Last Update Date | 12/12/2008 |
Medicare PECOS PAC ID | 7517014376 |
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Medicare Enrollment ID | O20090414000020 |
Identifier | Type | State | Issuer |
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1861637381 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103G00000X | Clinical Neuropsychologist | MD421627 (Pennsylvania) | Primary |
Provider Name | Yang Shan |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1841243003 PECOS PAC ID: 0941261002 Enrollment ID: I20041021000817 |
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