1861446908 NPI number — DR. HERBERT N AVART DO

Table of content: BRIANNA ALYSSA CHURCH LMSW (NPI 1801571351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861446908 NPI number — DR. HERBERT N AVART DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AVART
Provider First Name:
HERBERT
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1861446908
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
537 ATTERBURY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VILLANOVA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19085-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-225-1899
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1999 SPROUL RD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
BROOMALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19008-3508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-356-6250
Provider Business Practice Location Address Fax Number:
610-353-2109
Provider Enumeration Date:
05/22/2006

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: 225400000X , with the licence number:  0S004208L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225400000X , with the licence number: OS004208L , 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)





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