Healthcare Provider Details

I. General information

NPI: 1285791012
Provider Name (Legal Business Name): MICHAEL F. RAFFERTY D.O. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 HUNTINGDON PIKE SUITE 256
MEADOWBROOK PA
19046-8004
US

IV. Provider business mailing address

1650 HUNTINGDON PIKE SUITE 256
MEADOWBROOK PA
19046-8004
US

V. Phone/Fax

Practice location:
  • Phone: 215-938-1070
  • Fax: 215-938-0250
Mailing address:
  • Phone: 215-938-1070
  • Fax: 215-938-0250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS006731L
License Number StatePA

VIII. Authorized Official

Name: ERICA RAFFERTY
Title or Position: OFFICE MANAGER
Credential:
Phone: 215-938-1070