Provider Demographics
NPI:1447478797
Name:GUR, RUBEN C (PHD)
Entity type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:C
Last Name:GUR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:10 GATES PAVILION - HUP
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4283
Mailing Address - Country:US
Mailing Address - Phone:215-615-3604
Mailing Address - Fax:215-662-7903
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:10 GATES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-2826
Practice Address - Fax:215-662-7903
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002389L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist