| St. Regis Psychological & Educational Assoc.ltd | |
|
822 Pine St Suite 4a Philadelphia PA 19107-6187 | |
| (215) 923-5803 | |
| (215) 923-5758 |
| Full Name | St. Regis Psychological & Educational Assoc.ltd |
|---|---|
| Speciality | Psychologist |
| Location | 822 Pine St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Vincent John Gioe (PRESIDENT) |
| Authorized Official Contact | 2159235803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Regis Psychological & Educational Assoc.ltd 822 Pine St Suite 4a Philadelphia PA 19107-6187 Ph: (215) 923-5803 | St. Regis Psychological & Educational Assoc.ltd 822 Pine St Suite 4a Philadelphia PA 19107-6187 Ph: (215) 923-5803 |
| NPI Number | 1841336880 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5890941249 |
|---|---|
| Medicare Enrollment ID | O20120820000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841336880 | NPI | - | NPPES |
| 2907367 | Other | PA | AETNA |
| 0063161000 | Other | PA | BLUE SHIELD |
| ST 888479 | Other | PA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS002386-L (Pennsylvania) | Primary |
| Provider Name | Adrienne Gioe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437295441 PECOS PAC ID: 6103087853 Enrollment ID: I20120405000582 |
| Provider Name | Vincent J. Gioe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932245966 PECOS PAC ID: 2062668411 Enrollment ID: I20120820000107 |
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