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Organization
PENNSYLVANIA PSYCHIATRIC MEDICAL SERVICES
Active
Organization
PENNSYLVANIA PSYCHIATRIC MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DALY (CHIEF EXECUTIVE OFFICER)
(717) 782-4742
Entity
Organization
Contact information
Practice address
2501 N 3RD ST, HARRISBURG, PA 17110-1904
(717) 782-6420
Mailing address
PO BOX 826929, PHILADELPHIA, PA 19182-6929
(717) 782-6420
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020963800
—
PA
Enumeration date
11/16/2017
Last updated
11/16/2017
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