Provider Demographics
NPI:1053374850
Name:FENSTERMACHER, NANCY M (PSYD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:FENSTERMACHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:FENSTERMACHER ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:118 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 S FRONT STREET
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8360
Practice Address - Fax:717-231-8358
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007110L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA632299OtherHIGHMARK BLUE SHIELD
PAP00459477OtherRAIL ROAD MEDICARE
PA7232063OtherAETNA
PA0019202950001Medicaid
PA091602OtherUNITED BEHAVIORAL HEALTH
PA2102427OtherFIRST HEALTH
PA03155301OtherBLUE CROSS/CAIC
PA0019202950001Medicaid
PAP00459477OtherRAIL ROAD MEDICARE