Individual
DR. JOSEPH P. PRIMAVERA III
Active
Individual
DR. JOSEPH P. PRIMAVERA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS 0047-16L
PW
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063157000
MAGELLAN HEALTH SERVICES
PA
01
—
250823000
MAGELLAN PROVIDER MIS
PA
01
—
4404301
AETNA
PA
Enumeration date
03/09/2007
Last updated
07/09/2007
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