Individual
MR. BRIAN KIRBY FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED
Contact information
Practice address
426 S THIRD ST, STE 201, LEMOYNE, PA 17043
(717) 737-2448
(717) 774-1435
Mailing address
352 FUTURITY DR, CAMP HILL, PA 17011
(717) 774-1218
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS004024L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633901
CAPITAL BLUE CROSS
PA
01
—
F0144575
HIGHMARK BLUE SHIELD
PA
Enumeration date
07/11/2006
Last updated
07/08/2007
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