Mary Ten Broech Durso, LICENSED PSYCHOLOGIS is a
Psychologist based in Moutaintop, Pennsylvania. Mary Ten Broech Durso is licensed to practice in Pennsylvania (license number PS006873L) and her current practice location is
359 S Mountain Blvd, Suite C2, Moutaintop, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at
(570) 403-5080.
NPI number for Mary Ten Broech Durso is 1942259619 and her current mailing address is Hc 88 Box 434, Pocono Lake, Pennsylvania. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1942259619.
Healthcare Provider's Profile
| Full Name | Mary Ten Broech Durso |
|---|
| Gender | Female |
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| Speciality | Psychologist |
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| Location | 359 S Mountain Blvd, Moutaintop, Pennsylvania |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1942259619
- Provider Enumeration Date: 05/09/2006
- Last Update Date: 04/09/2014
Medical Identifiers
Medical identifiers for Mary Ten Broech Durso such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942259619 | NPI | - | NPPES |
| 0016193400002 | Medicaid | PA | |
| 080953 | Other | PA | FIRST PRIORITY HLTH |
| 2056962 | Other | PA | CIGNA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | PS006873L (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Ten Broech Durso is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary Ten Broech Durso, LICENSED PSYCHOLOGIS
Hc 88 Box 434,
Pocono Lake, PA 18347-9512
Ph: (570) 646-0870 | Mary Ten Broech Durso, LICENSED PSYCHOLOGIS
359 S Mountain Blvd, Suite C2,
Moutaintop, PA 18707
Ph: (570) 403-5080 |
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