1598911240 NPI number — MR. WILLIAM JAMES HARVEY IV CERT'D ADV. ROLFER

Table of content: MS. CECILIA ARELI GAMEZ (NPI 1265657688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598911240 NPI number — MR. WILLIAM JAMES HARVEY IV CERT'D ADV. ROLFER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVEY
Provider First Name:
WILLIAM
Provider Middle Name:
JAMES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
IV
Provider Credential Text:
CERT'D ADV. ROLFER
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARVEY
Provider Other First Name:
BILL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
C. A. ROLFER
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1598911240
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901B MAIN ST
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19127-2191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-508-3065
Provider Business Mailing Address Fax Number:
215-508-2831

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901B MAIN ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19127-2191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-508-3065
Provider Business Practice Location Address Fax Number:
215-508-2831
Provider Enumeration Date:
08/13/2008

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: 174400000X , with the licence number:  N. A. ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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