Provider Demographics
NPI:1861870263
Name:MANFREDI, ROSEMARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:
Last Name:MANFREDI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 STREET RD STE 407
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2023
Mailing Address - Country:US
Mailing Address - Phone:215-515-2388
Mailing Address - Fax:
Practice Address - Street 1:3331 STREET RD STE 407
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2023
Practice Address - Country:US
Practice Address - Phone:215-515-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0001022103TC0700X
PAPS016960103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical