Healthcare Provider Details

I. General information

NPI: 1174563712
Provider Name (Legal Business Name): WILLIAM C MCCAFFERTY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 VILLAGE SQ, LOGAN SQ SUITE 1
NEW HOPE PA
18938
US

IV. Provider business mailing address

536 MOREBORO RD
HATBORO PA
19040-3953
US

V. Phone/Fax

Practice location:
  • Phone: 215-862-4195
  • Fax: 215-862-4197
Mailing address:
  • Phone: 215-443-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006682L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: