Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Main Line Integrative Psychiatry

Organization Psychiatry Physician · NPI 1457227084

Main Line Integrative Psychiatry is a Psychiatry Physician in Bala Cynwyd, Pennsylvania. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

10 Union Ave Apt 301
Bala Cynwyd, PA 19004-3421
Phone: (484) 222-0314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1457227084
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Derosa — Owner · (484) 222-0314
NPI enumeratedOctober 13, 2025
Last updated in NPPESOctober 13, 2025
Certification dateOctober 12, 2025
Mailing address10 Union Ave Apt 301, Bala Cynwyd, PA 19004-3421

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