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Specialty Name Address Affidavit Effective Date
01 - General Practice Braverman, Eric 142 Bellevue Ave Penndel, PA 19047-5254 01/01/2006
01 - General Practice Laseter, Christopher 101 Good Drive Suite 4 Lancaster, PA 17603-2390 10/01/2000
01 - General Practice Linder, Henry 6 Cross Country Complex Tunkhannock, PA 18657 01/02/2007
01 - General Practice Merizalde, Bernardo 21 Cynwyd Rd Bala Cynwyd, PA 19004 12/03/2001
01 - General Practice Sanet, Steven 8 East Baltimore Avenue Clifton Hgts, PA 19018 01/21/2003
01 - General Practice Swami, S. Chandra 701 North Hermitage Road Hermitage, PA 16148 01/01/2008
04 - Otolaryngology Kerry, Roy 17 Sixth Ave Greenville, PA 16125 01/01/2008
07 - Dermatology Sciara, Christine 1595 Paoli Pike Suite 105 West Chester, PA 19380 04/01/2002
08 - Family Practice Bach, Gregory 2415 N Broad Street Colmar, PA 18915-9406 04/01/2001
08 - Family Practice Badgio, Daphne (Goldberg) 2501 Reid Street Philadelphia, PA 19146-3900 01/01/2006
08 - Family Practice Busko, Carlton 207 Market Street Halifax, PA 17032 04/01/2003
08 - Family Practice Cohen, Alice 160 North Point Blvd Suite 113 Lancaster, PA 17601 04/01/2006
08 - Family Practice Corson, Ann 731 Street Road, Suite 1 Cochranville, PA 19330 07/01/2004
08 - Family Practice Corson, Barry 649 Germantown Pike Plymouth Meeting, PA 19462 10/01/2004
08 - Family Practice Gallagher, Martin 6402 State Route 30, Jeannette, PA 15644 03/14/2008
08 - Family Practice Garabedian, J.A. 1012 West 9th Street King of Prussia, PA 19406 03/13/2008
08 - Family Practice Lagan, Jane 271 W Cedar Street Hazelton, PA 18201 07/01/2001
08 - Family Practice Lipschutz, Steven 170 W Olney Avenue Philadelphia, PA 19120 10/01/2006
08 - Family Practice Littzi, Carolann 29 North Memorial Highway Shavertown, PA 18078 10/01/2005
08 - Family Practice Maulfair, Conrad Jr. 403 N Main Street Topton, PA 19562-1412 07/01/2005
08 - Family Practice McGinley, Gregory 1045 First Avenue King of Prussia, PA 19406 10/01/2005
08 - Family Practice Murdoch, Winslow 1450 Boot Road West Chester, PA 19380-2928 04/01/2004
08 - Family Practice Newman, Marc 6 East Willow Grove Avenue Philadelphia, PA 19118-3426 01/01/2008
08 - Family Practice Newsom, John 1588 Woodside Road Yardley, PA 19067-2611 01/01/2008
08 - Family Practice Palmiero, Paul 537 S 46th Street Philadelphia, PA 19143-2101 01/01/2005
08 - Family Practice Peirsel, Paul 505 Poplar Street Meadville, PA 16335 04/01/2007
08 - Family Practice Silverman, Russell 100 N Presidential Blvd Bala Cynwyd, PA 19004 02/14/2003
08 - Family Practice Vonkeil, Derik 501 N 17th Street Allentown, PA 18104-5044 02/16/1998
08 - Family Practice Whitney, Charles 1121 General Washington Memorial Blvd Washington Crossing, PA 18977 04/01/2005
11 - Internal Medicine Bazzan, Anthony

2505 Boulevard of the Generals Valley Forge Business Center Jeffersonville, PA 19403

07/01/2007
11 - Internal Medicine Halbert, Steven 2553 Ashbourne Road Wyncote, PA 19095 01/09/2008
11 - Internal Medicine Harvey, Barbara 108 North Elmira Street Athens, PA 18810 01/01/2004
11 - Internal Medicine Hauptman, William 10 Penn Center 1801 Market Street Suite 200 Philadephia, PA 19103 04/01/2007
11 - Internal Medicine McGinley, Gregory 4536 Fir Drive Nazareth, PA 18064 10/01/2005
11 - Internal Medicine Mulders, Hubb 18 Paoli Pike Paoli, PA 19301 12/15/2002
11 - Internal Medicine Spitz, Lawrence Penn Executive Diagnostic Center, Inc 1801 Market Sreet, Suite 200 Philadelphia, PA 19103 04/01/2007
11 - Internal Medicine Warshaw, Joel 2000 Oxford Drive Suite 440 Bethel Park, PA 15102 01/01/2008
11 - Internal Medicine Weiss, Robert 191 Presidenital Blvd Bala Cynwyd, PA 19004-1207 01/01/2006
13 - Neurology Banka, Reena 2101 Brighton Street Philadelphia, PA 19149 07/01/2007
13 - Neurology Knobler, Robert 467 Pennsylvania Avenue Suite 108 Fort Washington,PA 19034 04/01/2002
16 - Obstetrics/Gynecology Castelbaum, Arthur 1650 Huntington Pike Suite 154 Meadowbrook, PA 19046 01/01/2008
16 - Obstetrics/Gynecology Delaney, Melissa 606 East Marshall Street, Suite 206 West Chester, PA 19380 04/01/2008
16 - Obstetrics/Gynecology Engle, Eileen 847 Easton Road Suite 2300 Warrington, PA 18976 01/01/2003
16 - Obstetrics/Gynecology Freedman, Martin 1650 Huntington Pike Suite 154 Meadowbrook, PA 19046 01/01/2008
16 - Obstetrics/Gynecology Gocial, Benjamin 1650 Huntington Pike Suite 154 Meadowbrook, PA 19046 01/01/2008
16 - Obstetrics/Gynecology Gutmann, Jacqueline 1650 Huntington Pike Suite 154 Meadowbrook, PA 19046 01/01/2008
16 - Obstetrics/Gynecology Reich, Harry 245 N Memorial Hwy Shavertown, PA 18708-1129 07/01/2002
18 - Ophthalmology Hall, Neal 1811 Bethlehem Pike Flourtown, PA 19031 07/01/2008
19 - Oral Surgery Balatgek, Tammy 2433 Morgantown Rd, Suite 200 Reading, PA 19607 05/10/2007
19 - Oral Surgery Balshi, Thomas 467 Pennsylvania Avenue Suite 201 Fort Washington, PA 19034 12/11/2006
19 - Oral Surgery Humes, Helene 720 Dorseyville Road Pittsburgh, PA 15238 12/18/2007
19 - Oral Surgery Lahar, Craig 200 Cumberland Parkway Mechancisburg, PA 17055 04/01/2005
19 - Oral Surgery Laudenbach, Joel 1520 Locust Street, Suite 600 Philadelphia, PA 19102 10/06/2005
19 - Oral Surgery Magida, Edward 7 Cambridge Lane Newton, PA 18940 07/07/2006
19 - Oral Surgery Marcus, Edward 712 Floral Vale Blvd Yardley, PA 19067 07/07/2006
19 - Oral Surgery Marks, Manuel 712 Floral Vale Blvd Yardley, PA 19067 07/07/2006
19 - Oral Surgery Radnor, Leonard 157 Waterdam Road Suite 140 McMurray, PA 15317-2573 10/18/2004
19 - Oral Surgery Reigart, Brian 26 Roth Church Road Spring Grove, PA 17362 07/07/2006
19 - Oral Surgery Segal, Marc 1205 Langhorne Newton Rd Suite 207 Langhorne, PA 19047-1223 01/01/2006
20 - Orthopedic Surgery Sapega, Alexander 3400 Horozon Drive Philadelphia, PA 19104-4204 02/08/1998
20 - Orthopedic Surgery Sidor, Michael 250 Lankenau Med Bldg Wynnewood, PA 19096 02/08/1998
24 - Plastic & Reconstructive Surgery Levin, Richard 1608 Lititz Pike Lancaster, PA 17601 04/01/2007
25 - Physical Medicine & Rehabilitation Cohen, Randy 160 North Pointe Blvd, Suite 115 Lancaster, PA 17601 01/01/2008
25 - Physical Medicine & Rehabilitation Goldstein, David 9401 McKnight Road Suite 301B Pittsburgh, PA 15237 01/01/1999
26 - Psychiatry Abel, David 1638 Amity Road Rydal, PA 19046 10/01/2005
26 - Psychiatry Altman, Linda 1616 Walnut Street Suite 2114 Philadelphia, PA 19103 03/16/2004
26 - Psychiatry Baurer, Frederic 111 W 49th Street Philadelphia, PA 19139-1718 10/01/2005
26 - Psychiatry Benfield, Thomas 1015 Chestnut Street Suite 1013 Philadelphia, PA 19107-4310 07/01/1998
26 - Psychiatry Bloom, Peter 950 Haverford Rd Suite 302 Bryn Mawr, PA 19010-3851 07/01/1999
26 - Psychiatry Blum, Lawrence 2400 Chestnut Street Suite 2810 Philadelphia, PA 19103-4325 01/01/2004
26 - Psychiatry Bowring, Margaret Price 950 Haverford Road Bryn Mawr, PA 19010 10/01/2004
26 - Psychiatry Chastka, Edward 999 Berkshire Bldv, Suite 130 Wyomissing, PA 19610 02/06/2008
26 - Psychiatry Chen, Liu Lin-Li Andre Plaza, Suite 304 8035 McKnight Road Pittsburgh, PA 15237 01/01/2008
26 - Psychiatry Cudemo, Regina 520 E Broad Street Bethlehem, PA 19401 03/24/2004
26 - Psychiatry Demichele, Sara 30 Market St Philadelphia PA 19104 07/01/2008
26 - Psychiatry Digiacomo, W J 121 Coulter Avenue Ardmore, PA 19083-2610 01/26/1999
26 - Psychiatry Doyle, Harry 230 South 22nd Street Philadelphia, PA 19103 04/01/2007
26 - Psychiatry Felins, Kelly 426 Mulberry Street Scranton, PA 18503-1531 04/15/2008
26 - Psychiatry Fischer, Newell 658 Black Rock Road Bryn Mawr, PA 19010 07/01/2008
26 - Psychiatry Fitzgibbons, Richard 100 4 Falls Corp Ctr Suite 112 W Conshohocken, PA 19428 04/01/1998
26 - Psychiatry Foster, Howard 401 Shady Avenue Suite C202 Pittsburgh, PA 15206-4800 07/01/2004
26 - Psychiatry Geiger, Mary 875 County Line Road Suite 104 Bryn Mawr, PA 19139-2718 07/01/1999
26 - Psychiatry Gilofoil, James 864 Countly Line Rd Bryrn Mawr, PA 19010-2516 01/05/1998
26 - Psychiatry Glijansky, Alex 1579 Old York Road Abington, PA 19001 01/07/2008
26 - Psychiatry Goubert, Debrin 507 Hegner Way Sewickley PA 15143 05/01/2008
26 - Psychiatry Greer, Brendan 4025 Chestnut Street Philadelphia, PA 19104-3054 10/01/2004
26 - Psychiatry Grindlinger, Jonathan 11 Reitz Blvd Suite 202 Lewisburg, PA 17837 01/01/2008
26 - Psychiatry Gruenberg, Alan 950 Haverford Road Suite 362 Bryn Mawr, PA 19010-3851 10/01/2004
26 - Psychiatry Hetznecker, James 950 Haverford Rd Bryn Mawr, PA 19010-3851 10/01/2004
26 - Psychiatry Hirsch, Stuart 401 Shady Avenue Suite C203 Pittsburgh, PA 15206-4800 07/01/2002
26 - Psychiatry Hole, Richard 1601 Walnut Street Philadelphia, PA 19102-2944 01/01/2004
26 - Psychiatry Kersun, Jonathan 110 Park Ave Swarathmore, PA 19081 07/01/2008
26 - Psychiatry Konia, Charles Spring Hill Farm Easton, PA 18966-2105 01/21/1998
26 - Psychiatry Lichtman, Craig 2031 Locust Street Lobby West Philadelphia, PA 19103 01/01/2008
26 - Psychiatry Lipschutz, Marc 2200 Benjamin Franklin Parkway #E1509 Philadelphia, PA 19130 01/01/2007
26 - Psychiatry Lizzi, Luciano 121 Coulter Ave Ardmore PA 19003 10/01/2008
26 - Psychiatry Lustig, Herbert 15 Presidential Blvd Suite 203 Bala Cynwyndd, PA 19004-1006 01/26/1998
26 - Psychiatry Marcel, Susan 1315 Walnut Street Suite 1700 Philadelphia, PA 19107 07/01/2006
26 - Psychiatry Mazza, Dominic 500 Wheeler Ave Scranton, PA 18510-2561 04/01/2002
26 - Psychiatry McCarthy, Michael 2400 Chestnut Street #1409 Philadelphia, PA 19103 04/01/2007
26 - Psychiatry Mendelsohn, Sylvia 401 Shady Avenue Suite 204 Pittsburgh, PA 15206 09/07/2007
26 - Psychiatry Miller, Michael 1525 Locust St Philadelphia PA 10/01/2008
26 - Psychiatry Mira, John 115 S Saint Johns Drive Camp Hill, PA 17011-4147 09/01/2003
26 - Psychiatry Ouligian, John 121 Coulter Avenue Ardmore, PA 19083-2610 10/01/2003
26 - Psychiatry Price, Trevor 950 Haverford Road Bryn Mawr, PA 19010 07/01/2003
26 - Psychiatry Raines, Jonathan 1629 Monk Street Gladwine, PA 19015-1349 01/30/1998
26 - Psychiatry Reitano, John 121 Coulter Avenue Ardmore, PA 19083-2610 07/01/2000
26 - Psychiatry Rohtbart, Meyer 191 Presidential Blvd Suite 110 Bala Cynwyd, PA 19004 04/01/2007
26 - Psychiatry Rolfe, Steven 4 Elliott Ave Bryn Mawr, PA 19010 01/25/2007
26 - Psychiatry Schmukler, Anita One Bala Avenue Suite 12 Bala Cynwyd, PA 19004 09/14/2006
26 - Psychiatry Scott, Paul 401 Shady Ave Apt C202 Pittsburgh, PA 15206-4800 07/01/2002
26 - Psychiatry Sherr, Virginia 47 Crescent Dr Holland, PA 18966-2105 01/01/1999
26 - Psychiatry Slovak, James 321 Spruce Street Suite1200 Scranton, PA 18503 03/14/2007
26 - Psychiatry Summers, Richard 950 Haverford Road Suite 302 Bryn Mawr, PA 19010-3851 10/01/2004
26 - Psychiatry Vaccaro, Michael 25 Washington Lane Wyncote House Wyncote, PA 19095-1403 07/01/1998
26 - Psychiatry Volpicelli, Joseph 40 W Evergreen Ave Suite 106 Philadelphia, PA 19118 01/01/2008
26 - Psychiatry Webb, Elizabeth 220 North Bent Road Wyncote, PA 19095 11/30/2007
26 - Psychiatry Whitman, Sarah 8627 Germantown Ave Philadelphia, PA 19118 11/15/2006
37 - Pediatrics Shapiro, Barbara 1826 Delancey Place, Philadelphia, PA 19103 01/18/2008
62 - Indepnedently Practicing Psychologist Ferrell, D. Keith 111 North Franklin Street Wilkes-Barre, PA 18701-1401 04/01/2006
62 - Indepnedently Practicing Psychologist Robbins, Jeffrey 83 Hillcroft Way Newtown, PA 18940-2323 07/01/2005
66 - Rheumatology Mozayeni, Robert B., Md 9715 Medical Ctr Dr S-258 Rockville, MD 20850-3320 08/21/2006
68 - Clinical Psychologist Allison, Kelly 3535 Market St Suite 3108 Philadelphia, PA 19104 04/01/2007
68 - Clinical Psychologist Bopp, Michael 191 Presidenital Blvd Bala Cynwyd, PA 19004-1207 01/01/2004
68 - Clinical Psychologist Chrestman, Kelly 3535 Market Street Philadelphia, PA 19104 10/01/2004
68 - Clinical Psychologist DeMuth, Nancy 650 N 12th Street Lemoyne, PA 17043-1216 10/01/2004
68 - Clinical Psychologist Fischetti, Mario 258 42nd Street Pittsburgh, PA 15201 10/01/2004
68 - Clinical Psychologist Foa, Edna 3535 Market Street Philadelphia, PA 19104 10/01/2004
68 - Clinical Psychologist Franklin, Martin 3535 Market Street Philadelphia, PA 19104 10/01/2004
68 - Clinical Psychologist Hembree,Elizabeth 3535 Market Street Philadelphia, PA 19104-6021 10/01/2004
68 - Clinical Psychologist Huppert, Jonathan 3535 Market Street Philadelphia, PA 19104 10/01/2004
68 - Clinical Psychologist Jacobs, Julie 3535 Market St. Suite 2028 Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Kumar, Vanshi 3535 Market Street Philadelphia, PA 19104 01/01/2008
68 - Clinical Psychologist Layden, Mary Anne 3535 Market St. 2nd Floor Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Naar, Ray 211 Whitfield Street Med Ctr E Suite 540 Pittsburgh, PA 15206-3039 07/01/2005
68 - Clinical Psychologist Newman, Cory 3535 Market St. 2nd Floor Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Orbison, David 401 Shady Avenue Suite 102C Pittsburgh, PA 15206-4459 01/28/1998
68 - Clinical Psychologist Ramsay, John Russell 3535 Market St. 2nd Floor Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Riggs, David 3535 Market Street Philadelphia, PA 19104 10/01/2004
68 - Clinical Psychologist Ryan, Rita 3535 Market St. 2nd Floor Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Sarwer, David 3535 Market Street Suite 3108 Philadelphia, PA 19104 04/01/2007
68 - Clinical Psychologist Silverberg, Farrell 222 W Rittenhouse Square Philadelphia, PA 19103 04/01/2004
68 - Clinical Psychologist Treadwell, Thomas 3535 Market St. 2nd Floor Philadelphia, PA 19104-3309 01/01/2008
68 - Clinical Psychologist Velletri, Andrea 128 North Craiig Street Pittsburgh, PA 15213-2744 01/26/1998
68 - Clinical Psychologist Yalof, Jed 12 Veterans Square Suite 202 Media PA 19063-3129 01/01/2000
69 - Clinical Psychologist Baum-Baicker, Cynthia 1845 Walnut Street, Ste 2323 Philadelphia, PA 19103 04/01/2008
71 - Registered Dietician Diamond, Andrea Gidding 44 Union Ave Bala Cynwyd, PA 19004 07/01/2007
72 - Pain Management Palmerio, Paul 501-507 South 12th Philadelphia, PA 19147 01/01/2005
80 -Clinical Social Worker Coffey, William 4025 Chestnut Street, 1st Floor Philadelphia, PA 19104 04/01/2008
80 -Clinical Social Worker Fraley, Karen Kimberton , PA 19442 04/01/2007
80 -Clinical Social Worker Levine, Susan 631 Moreno Road Penn Valley, PA 19072 01/01/2003
80 -Clinical Social Worker Naugle, Rebecca 3535 Market St. 2nd Floor, Room 2026 Philadelphia, PA 19104-3309 01/01/2008
80 -Clinical Social Worker Robbins, Joan 83 Hillcroft Way Newtown, PA 18940 07/01/2004
80 -Clinical Social Worker Smullens, Sarakay The Drake #2901 1512 Spruce Street Philadelphia, PA 19102-4560 04/01/2007
93 - Emergency Medicine Perry, David 4315 Shimerville Rd Emmaus, PA 18049 07/01/2007
93 - Emergency Medicine Pierotti, Aldino III 730 Holiday Drive Pittsburgh, PA 15220 04/01/2005
93 - Emergency Medicine Smith, Harold 127 North Street Bloomsburg, PA 17815 04/01/2004
98 - Gynecological/Oncology Warner, Wendy 940 Town Center Drive Suite F-90 Langhorne, PA 19047 10/01/2004
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