1346566338 NPI number — QUINCY O HARBERGER M.D.

Table of content: QUINCY O HARBERGER M.D. (NPI 1346566338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346566338 NPI number — QUINCY O HARBERGER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARBERGER
Provider First Name:
QUINCY
Provider Middle Name:
O
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346566338
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 CONCORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-9001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-812-4053
Provider Business Mailing Address Fax Number:
717-775-5006

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 ROOSEVELT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404-2244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-812-4053
Provider Business Practice Location Address Fax Number:
717-775-5006
Provider Enumeration Date:
04/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD447087 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30153204 . This is a "AMERIHEALTH CARITAS - CE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P011837 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30079617 . This is a "AMERIHEALTH CARITAS - THFP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102825284 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30153658 . This is a "AMERIHEALTH CARITAS - WRC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 786574 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30153367 . This is a "AMERIHEALTH CARITAS - HFM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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