DR. MOHAMED R. DATTU (NPI# 1821028119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821028119 |
| Entity Type | Individual |
| Full Name | DR. MOHAMED R. DATTU |
| Credential | M.D. |
| Practice Address |
600 Haverford Rd Ste 201 Haverford PA 19041-1139 |
| Mailing Address |
600 Haverford Rd Suite 201 Haverford PA 19041 |
| Practice Telephone | 7177756189 |
| Practice Fax Number | 8447268901 |
| Mailing Telephone | 7242884007 |
| Mailing Fax Number | 4122060128 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD421369 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK | 1588952 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1370 Washington Pike, Suite 303, Bridgeville, PA 150172862 | 4122060123 | 4122060128 |
| Street Address |
600 HAVERFORD RD STE 201 |
| City | HAVERFORD |
| State | PA |
| Zip Code | 19041-1139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619580495 | Brenda Del Carmen | Counselor | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2020-08-31 |
| 1063021160 | Sarah Martyn | Massage Therapist | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2020-07-24 |
| 1417575770 | Ronnal Demeko Freeman | Counselor | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2020-07-13 |
| 1740809110 | Mary Alysse Metzger | Counselor | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2020-04-15 |
| 1477106607 | Marquisha Dunston | Social Worker | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2019-07-17 |
| 1588126726 | Kimberly Ann Gora-buck | Social Worker | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2019-04-05 |
| 1952842296 | Nanette Farrell | Counselor | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2017-03-20 |
| 1063576387 | Stacie A Nawn | Counselor | 600 Haverford Rd Ste 201, Haverford, PA 19041-1139 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285172999 | Linda G Tessler | Psychologist | 103 Green Lane, Haverford, PA 19041 | 2017-02-02 |
| 1255626529 | Haverford College Health Services | Registered Nurse | 370 Lancaster Avenue, Haverford, PA 19041 | 2011-06-15 |
| 1316256050 | Deborah Jean Gunton | Psychologist | 349 West Lancaster Avenue, Suite 201, Haverford, PA 19041 | 2010-09-29 |
| 1629390695 | Moira L Kowalczyk | Occupational Therapist | 551 West Lancaster Avenue, Haverford, PA 19041 | 2010-02-18 |
| 1528398724 | John Antoniades | Radiology | 404 Richard Knoll, Haverford, PA 19041 | 2010-01-11 |
| 1215264262 | Robert Frederick Plotkin | Pediatrics | 3300 Darby Rd., Apt 1310, Haverford, PA 19041 | 2009-11-12 |
| 1396984662 | Joel E Wasley | Dentist | 268 West Montgomery Avenue, Haverford, PA 19041 | 2009-02-11 |
| 1538325105 | Joseph Anthony Gwiszcz Jr. | Pediatrics | 600 Haverford Road., Suite 100, Haverford, PA 19041 | 2008-08-04 |
| 1619142262 | Gregory Stephen Wilson | Occupational Therapist | 551 W Lancaster Avenue, Staffing Plus, Haverford, PA 19041 | 2008-04-24 |
| 1972790319 | Lene H Larsen | Psychologist | 349 W. Lancaster Avenue, Suite 103, Haverford, PA 19041 | 2007-10-01 |
| Find all providers in zip 19041 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922367820 | Charles A Altman | Psychiatry & Neurology | 632 Robinson Ln, Haverford, PA 19041-1927 | 2012-05-11 |
| 1821250275 | Ruth Sylvia Garfield | Psychiatry & Neurology | 355 Lancaster Ave # D, Haverford, PA 19041-1547 | 2008-06-26 |
| 1538326699 | John Alan Herring | Psychiatry & Neurology | 101 Cheswold Ln, Haverford, PA 19041-1865 | 2008-05-16 |
| 1770783938 | Susan E Rushing | Psychiatry & Neurology | 622 Haverford Rd, Haverford, PA 19041-1102 | 2007-07-24 |
| 1790995629 | Steven Marc Sokoll | Psychiatry & Neurology | 320 Quarry Ln, Haverford, PA 19041-1723 | 2007-05-22 |
| 1154541712 | Elena T Delbusto | Psychiatry & Neurology | 349 W. Lancaster Ave, Suite 206, Haverford, PA 19041 | 2007-04-26 |
| 1699841551 | Robert Eric Stake | Psychiatry & Neurology | 385 West Lancaster Avenue, Suite 207, Haverford, PA 19041-1551 | 2006-11-24 |
| 1407940323 | Gary Micheal Flaxenburg | Psychiatry & Neurology | 385 W. Lancaster Avenue, Haverford Square Suite 207, Haverford, PA 19041 | 2006-10-03 |
| 1760404669 | Steven M Eisen | Psychiatry & Neurology | 33 Meadows Ln, Haverford, PA 19041-1123 | 2006-07-23 |
| 1083908388 | Main Line Mental Health LLC | Psychiatry & Neurology | 349 Lancaster Ave, Suite 103, Haverford, PA 19041-1500 | 2011-06-03 |
| Find all providers in HAVERFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.