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General NPI Number Information
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NPI Number | 1477091627
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Entity Type | Organization
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Legal Business Name | PA. PSYCHIATRIC INS
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 2501 N 3RD ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1904
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Country | US
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Telephone | 717-782-2736
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Fax | 717-782-4661
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Provider Business Mailing Address
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Address Line | 2501 N 3RD STREET
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City | HARRISBURG
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State | PA
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Zip | 17110
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Country | US
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Telephone | 717-782-2736
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Fax | 717-782-4661
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. WALTER H BUFFORD III
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Credential | MHS
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Telephone | 717-782-2736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 106500000X
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License Number State | PA
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