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NPI Code Detail

MEDICARE: MR. ARTHUR JOSEPH DUFFY III ATC, PT

MEDICARE: MR. ARTHUR JOSEPH DUFFY III ATC, PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251S0007XSports Physical TherapistPT-005504-LPA
22251S0007XSports Physical Therapist40QA00513500NJ
32255A2300XAthletic TrainerRT-00382-APA

General Provider Information

NPI Number : 1578556130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ARTHUR JOSEPH DUFFY III ATC, PT
Provider Business Mailing Address
First Line : 1 UNIVERSITY PL
Second Line : WIDENER UNIVERSITY
City : CHESTER
State : PA
Zip : 19013-5700
Country : US
Telephone Number : 610-499-4445
Fax Number : 610-499-4481
Provider Business Practice Location Address
First Line : 1 UNIVERSITY PL
Second Line : WIDENER UNIVERSITY
City : CHESTER
State : PA
Zip : 19013-5700
Country : US
Telephone Number : 610-499-4445
Fax Number : 610-499-4481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 09/11/2025

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