Provider Demographics
NPI:1750990263
Name:PATTEY FONG PSYCHOLOGY ASSOCIATES
Entity type:Organization
Organization Name:PATTEY FONG PSYCHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATTEY
Authorized Official - Middle Name:LEEANNE
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-526-1900
Mailing Address - Street 1:1062 E LANCASTER AVE STE 25
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1567
Mailing Address - Country:US
Mailing Address - Phone:610-526-1900
Mailing Address - Fax:
Practice Address - Street 1:1062 E LANCASTER AVE STE 25
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1567
Practice Address - Country:US
Practice Address - Phone:610-526-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty