| Roman J Pastushak | |
|
555 City Ave Ste 210 Bala Cynwyd PA 19004-1141 | |
| (610) 660-8338 | |
| (610) 660-8339 |
| Full Name | Roman J Pastushak |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 555 City Ave, Bala Cynwyd, Pennsylvania |
| Authorized Official Name and Position | Roman Joseph Pastushak (PRES SOLE OWNER) |
| Authorized Official Contact | 2153641799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roman J Pastushak 67 Cynthia Dr Richboro PA 18954-1331 Ph: (215) 364-1799 | Roman J Pastushak 555 City Ave Ste 210 Bala Cynwyd PA 19004-1141 Ph: (610) 660-8338 |
| NPI Number | 1790774248 |
|---|---|
| Provider Enumeration Date | 10/18/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790774248 | NPI | - | NPPES |
| 7402114 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PS2609L (Pennsylvania) | Primary |
| 103TC1900X | Psychologist - Counseling | B10000525 (Delaware) | Secondary |
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